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Understanding Physical Activity-Related Information Needs and Communication Preferences among Consumers and Professionals:

Audience Research to Inform Physical Activity Guidelines Strategic Communication

ODPHP Generic Information Collection Request

OMB No. 0990-0281

Supporting Statement — Section A

Submitted January 9, 2017

Submitted to:

Sherrette Funn

Office of the Chief Information Officer

U.S. Department of Health and Human Services

Submitted by:

Frances Bevington

Strategic Communication and Public Affairs Advisor

Office of Disease Prevention and Health Promotion

U.S. Department of Health and Human Services

Section A — Justification

1. Circumstances Making the Collection of Information Necessary

In the United States, more than one-third of adults¹ and 17% of children² are obese. Obesity is related to many serious health conditions, including heart disease, stroke, type 2 diabetes and certain types of cancer. In 2008, the estimated annual medical cost of obesity in the United States was $147 billion.

According to the Centers for Disease Control and Prevention (CDC), a combination of factors — including behaviors like physical activity — are critical to preventing and treating obesity.³

The Office of Disease Prevention and Health Promotion (ODPHP) will be releasing the second

edition of the Physical Activity Guidelines in 2018. Based on the latest science, the Physical Activity Guidelines provides guidance on how children and adults can improve their health through physical activity. The Physical Activity Guidelines is an essential resource for health professionals and policymakers.

The success of the second edition of the Physical Activity Guidelines — in other words, the extent to which these recommendations affect Americans’ physical activity knowledge, attitudes, and behaviors — depends in part on the effectiveness of Physical Activity Guidelines outreach and communication.

In preparation for the release of the new guidance, ODPHP seeks to conduct formative research to inform a comprehensive communication plan to promote physical activity and the Physical Activity Guidelines resource. This research will also inform the development of effective iconography that relays key messages about physical activity. Ultimately, ODPHP also intends to develop information and tools that help consumers be more active and support the work of health and physical activity professionals and other stakeholders.

2. Purpose and Use of the Information Collection

To support these efforts, ODPHP wants to explore these audiences’ information needs, physical activity attitudes and behaviors, familiarity with the Physical Activity Guidelines, and preferences for channels, products, images, and brands.

In order to obtain this feedback, ODPHP proposes conducting focus groups with both consumers and health and physical activity professionals. Focus groups are the most efficient way to collect in-depth feedback on these audiences’ understanding and' use of the Physical Activity Guidelines, as well as information needs and preferences.

Consumer Focus Groups

ODPHP is seeking approval to conduct 12 in-person, 90-minute consumer focus groups with adults ages 35–64 (up to 8 participants for each group, 96 participants total). All participation is strictly voluntary.

In focus groups with consumers, ODPHP seeks insight into the following research questions:

• What beliefs, attitudes, and motivations influence consumers’ engagement in physical activity?

• What are consumers’ current physical activity behaviors? What individual- and structural-level barriers and facilitators exist related to consumers following the Physical Activity Guidelines?

• What differences exist between consumers’ physical activity goals and their actual physical activity behaviors? Why?

• How familiar are consumers with the Physical Activity Guidelines?

• What are consumers’ preferences for physical activity communication channels, images, and branding?

• What mobile health tools and technologies do consumers use to support physical activity? What mobile health tools and technologies have consumers used in the past, and what tools would they like to use in the future?

Professional Focus Groups

ODPHP is seeking approval to conduct 3 remote, 60-minute focus groups with health and physical activity professionals (up to 6 participants for each group, 18 participants total). All participation is strictly voluntary.

In focus groups with health and physical activity professionals, ODPHP will investigate the following research questions:

• How familiar are professionals with the Physical Activity Guidelines?

• What do professionals consider to be trusted sources of information about physical activity and health?

• What barriers and facilitators exist for professionals promoting the Physical Activity Guidelines in their work with patients or clients?

• What are professionals’ preferences for physical activity communication channels, images, and branding?

• What mobile health tools and technologies do professionals use to promote physical activity among patients or clients? What mobile health tools and technologies have professionals used in the past, and what tools would they like to use in the future?

Information Use

Following the focus groups, ODPHP will develop a summary report that details key findings. ODPHP will present findings in aggregate and will not collect or report information that identifies individual participants.

Focus groups with both consumers and health and physical activity professionals will provide critical insights that will inform strategic communication for the second edition of the Physical Activity Guidelines. ODPHP will use these findings to develop:

• An icon that promotes physical activity and motivates consumers to achieve the recommendations in the Physical Activity Guidelines

• A comprehensive strategic communication plan — with proposed messages, products, and channels — that supports the dissemination of the second edition of the Physical Activity Guidelines to both professionals and consumers

3. Use of Improved Information Technology and Burden Reduction

Focus groups with consumers will be conducted in person. To reduce participant burden, ODPHP will make every effort to plan focus groups at times and in locations convenient for participants (for example, accessible by public transportation).

To reduce participant burden, focus groups with health and physical activity professionals will be conducted remotely over the phone. Participants will be recruited through an email invitation.

Participants for all focus groups will be drawn from convenience samples. For all focus groups, ODPHP will use a laptop to take notes to save transcription time. To ensure that key themes and quotations are captured accurately, ODPHP will also audiotape all focus groups.

4. Efforts to Identify Duplication and Use of Similar Information

To our knowledge, there is no information of a similar nature that has been or is currently being collected. This is an exploratory study to allow ODPHP to better understand target audiences’ information needs, physical activity attitudes and behaviors, familiarity with the Physical Activity Guidelines, and preferences for channels, products, images, and brands.

5. Impact on Small Businesses or Other Small Entities

No small businesses will be impacted or involved in this data collection.

6. Consequences of Collecting the Information Less Frequently

This request is for one-time data collection. These data have not previously been collected elsewhere.

7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5

There are no special circumstances with this information collection package. This request fully complies with the regulation 5 CFR 1320.5 and will be voluntary.

8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency

This data collection is being conducted using the Generic Information Collection mechanism through ODPHP — OMB No. 0990-0281.

9. Explanation of Any Payment or Gift to Respondents

Incentives

Participants will be offered a cash incentive as a token of appreciation for their participation:

• Consumer participants: $75 for a 90-minute focus group

• Professional participants: $100 for a 60-minute focus group

Justification for Incentives

The proposed incentive amounts ($75 for consumers and $100 for professionals) have been shown to be the minimum required incentive to offset the challenges for these audiences to participate in a focus group. These challenges may include lost wages, transportation, and childcare, among others. Incentives ensure timely recruitment and decrease no-show rates.

The recruitment company will use incentives in order to recruit a diverse set of participants (ODPHP will retain copies of the incentive receipt forms on a secure server). The above amounts are consistent with standard practice for qualitative data collection efforts and experience with these populations on previous projects.

ODPHP has consulted with several recruitment firms in locations where focus groups will be held. These firms noted the minimum amounts necessary, based on their experience, to successfully recruit research participants — see below.

In Baltimore, MD, recruitment firms Observation Baltimore and L&E Research suggested:

• $75–100 for consumers

• $125 for professionals (no specific occupation)

• $400 for primary care providers

• $85 for personal trainers

In Indianapolis, IN, recruitment firm Indy Focus suggested:

• $100 for consumers

• $300–400 for primary care providers

• $100 for personal trainers

In Las Vegas, NV, recruitment firm Consumer Opinion Services suggested:

• $75–80 for consumers

• $150 for professionals (no specific occupation)

Recruitment firm Graham & Associates (based in Birmingham, AL, but with extensive experience recruiting in Jackson, MS) suggests:

• $75 for consumers

• $250–275 for primary care providers

• $125–150 for other professionals (no specific occupation)

In the recent past, incentives lower than the proposed amounts ($75 for consumers and $100 for professionals) have made it difficult to recruit these audiences and have had significant consequences. Examples include:

• OMB Control Number: 0923-0047. In Spring 2016, consumer focus groups for the CDC were compromised because of an incentive that was too low ($75). Before beginning recruitment, the recruitment firm noted that this amount would be too low to successfully recruit consumers for a 90-minute focus group. In order to ensure the recruit was successful, the focus groups were shortened to 60 minutes, which cost the researchers a total 90 minutes of data collection time. Ultimately, 5 recruits (out of a goal of 27 total participants) were “no-shows,” which further compromised researchers’ ability to collect valuable data.

• OMB Control Number: 0920-0572. In Spring 2015, a recruit for another HHS agency was unable to be completed using a lower incentive ($40). The recruitment firm contacted over 1,600 individuals for a 24-person focus group study. The recruitment firm could not complete the recruit at a $40 incentive and the study had to be canceled.

If ODPHP is unable to successfully recruit consumer and professional focus group participants in a timely manner, the consequences will be significant:

• ODPHP will be unable to communicate effectively about the Physical Activity Guidelines — critical guidance with the potential to impact physical activity nationwide and, ultimately, related chronic diseases such as obesity, heart disease, and diabetes

• ODPHP will waste funds either preparing for research that it cannot complete or contacting far more prospective participants than anticipated

• Consumers and health and physical activity professionals will receive communication about physical activity recommendations that may not reflect their behaviors, attitudes, or preferences, thereby imposing an undue burden and/or limiting their opportunities to see, understand, or act on this important information

10. Assurance of Confidentiality Provided to Respondents

The Privacy Act does not apply to this data collection. ODPHP will not collect any personally identifiable information from focus group participants. The focus group moderator’s guides and the participant information sheet — included in the consumer focus group protocols [see Attachment C (English) and Attachment D (Spanish)] and professional protocol (see Attachment F) — include confidentiality information for participants. Participants will also be instructed that they can stop their participation at any time.

11. Justification for Sensitive Questions

ODPHP does not anticipate that research participants will perceive questions as sensitive in nature. ODPHP will focus on collecting information that can inform physical activity-related information and tools that help both consumers and professionals. However, this information is key to understanding how to communicate with consumers and professionals about physical activity recommendations. Prior to the discussion, the moderator will inform participants that they may decline to respond if they are uncomfortable answering any question.

12. Estimates of Annualized Burden Hours and Costs

The estimate for burden hours is based on:

• Emails sent to and phone calls conducted with 288 prospective consumer participants, to recruit 96 consumer focus group participants. We estimate that each prospective consumer participant will spend a total of 10 minutes reading and responding to the recruitment email and answering screening questions over the phone. See the phone screener in Attachment A (English) and Attachment B (Spanish), and the recruitment email in Attachment C (English) and Attachment D (Spanish).

• Emails sent to and phone calls conducted with 54 prospective professional participants, to recruit 18 professional focus group participants. We estimate that each prospective professional participant will spend a total of 10 minutes reading and responding to the recruitment email and answering screening questions over the phone. See the phone screener in Attachment E and the recruitment email in Attachment F.

• Twelve 90-minute focus group discussions with a total of 96 consumer participants (up to 8 participants in each group). See protocol in Attachment C (English) and Attachment D (Spanish).

• Three 60-minute focus group discussions with a total of 18 professional participants (up to 6 participants in each group). See protocol in Attachment F.

For consumers, estimates for hourly burden are calculated using the mean hourly wage for all occupations ($23.23), because ODPHP aims to recruit diverse adults for consumer focus groups.⁴ Estimates do not adjust for the fact that some participants will not be employed, assuming that their time is of comparable value.

For professionals, estimates are based on mean hourly wages for each professional target audience, including physicians ($97.33), occupational therapists ($39.27), physical therapists ($41.25), personal trainers ($19.70), and exercise physiologists ($23.91).⁵ Table A-12 shows estimated burden and cost information. In addition to matching professionals’ hourly wages, ODPHP intends for incentives to offset other costs related to their participation (for example, transportation and childcare).

Table A-12: Estimated Annualized Burden Hours and Costs to Participants

Category of Participant	No. of Participants	Average Burden per Response	Total Burden Hours	Hourly Wage Rate	Total Participant Costs
Consumer Recruitment
Consumers	288	10/60	48	$23.23	$1,115.04
Professional Recruitment
Physicians	14	10/60	2.33	$97.33	$227.10
Occupational therapists	10	10/60	1.66	$39.27	$65.45
Physical therapists	10	10/60	1.66	$41.25	$68.75
Personal trainers	10	10/60	1.66	$19.70	$32.83
Exercise physiologists	10	10/60	1.66	$23.91	$39.85
Consumer Focus Groups
Consumers	96	1.5	144	$23.23	$3,345.12
Professional Focus Groups
Physicians	4	1	4	$97.33	$389.32
Occupational therapists	4	1	4	$39.27	$157.08
Physical therapists	4	1	4	$41.25	$165.00
Personal trainers	4	1	4	$19.70	$78.80
Exercise physiologists	2	1	2	$23.91	$47.82
Totals	456		219		$5,732.16

13. Estimates of Annualized Burden Hours and Costs

Participants may incur costs related to transportation or childcare, which ODPHP intends to offset with an adequate incentive.

14. Annualized Cost to the Government

Table A-14: Estimated Annualized Cost to the Federal Government

Expense	Number/ Amount	Cost/Hourly Wage Rate	Average Cost
Communication Researchers	240	$123.64	$29,673.60
Spanish Translator/Moderator	68	$96.80	$6,582.40
Support Staff	100	$66.52	$6,652.00
Consumer Recruitment Fee	100	$150.00	$15,000.00
Consumer Participant Incentives	100	$75.00	$7,500.00
Professional Participant Incentives	18	$100.00	$1,800.00
Travel (2 Staff)	3	$3,333.33	$10,000.00
Estimated Total Cost of Data Collection			$77,208.00

The estimated annual cost to the Federal government is $77,208.00.

15. Explanation for Program Changes or Adjustments

This is new data collection.

16. Plans for Tabulation and Publication and Project Time Schedule

The qualitative information shared by focus group participants will be collected via typed notes and audio recording. After each focus group is complete, contractor staff will review the written notes within 24 hours, and audiotapes will be transcribed. Contractor staff will analyze the data qualitatively by reviewing the session notes and pulling out the main themes from each set of discussions. These themes will be summarized. No names or other personal information will be reported in the summaries.

Proposed Timeline

Completion Date	Major Tasks/Milestones
October 2016	Develop focus group protocols and screening instruments
November 2016	Translate focus group protocols and screening instruments Submit request for OMB approval under existing generic clearance Plan for recruitment Plan for focus groups
January 2017	Recruit participants Finalize focus group logistics Conduct focus groups with professionals Begin conducting focus groups with consumers
February 2017	Finish conducting focus groups with consumers Begin analyzing professional focus group data
March 2017	Analyze consumer and professional focus group data Draft summary report of findings and recommendations

17. Reason(s) Display of OMB Expiration Data is Inappropriate

We are requesting no exemption.

18. Exceptions to Certification for Paperwork Reduction Act Submissions

There are no exceptions to the certification. These activities comply with the requirements in 5 CFR 1320.9.

Section A — List of Attachments

[IN SEPARATE FILES]

• Attachment A: Phone Screener for Consumer Focus Groups (English)

• Attachment B: Phone Screener for Consumer Focus Groups (Spanish)

• Attachment C: Consumer Focus Group Protocol (English)

• Attachment D: Consumer Focus Group Protocol (Spanish)

• Attachment E: Phone Screener for Professional Focus Groups

• Attachment F: Professional Focus Group Protocol

• Attachment G: Quick Association Exercise

• Attachment H: Collaging Activity

1 Adult Obesity Facts. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/obesity/data/adult.html

2 Childhood Obesity Facts. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/obesity/data/childhood.html

3 Adult Obesity Causes & Consequences. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/obesity/adult/causes.html

4 May 2015 National Occupational Employment and Wage Estimates, United States. Bureau of Labor Statistics. United States Department of Labor. Retrieved at http://www.bls.gov/oes/current/oes_nat.htm.

5 May 2015 National Occupational Employment and Wage Estimates, United States. Bureau of Labor Statistics. United States Department of Labor. Retrieved at http://www.bls.gov/oes/current/oes_nat.htm.