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Knowledge, Attitudes, and Practices of Healthcare Professionals Working in Schools Regarding Tickborne Disease Prevention and Lyme Disease in New York State and Maryland

Supporting Statement B for a New Generic Information Collection Request

OMB Control No. 0920-1150

Expiration Date 12/31/2019

March 19, 2019

Contact Information:

Lee Samuel

Office of Policy and Planning

National Center for Emerging and Zoonotic Infectious Diseases

Centers for Disease Control and Prevention

1600 Clifton Road, N.E., MS C-12

Atlanta, Georgia 30329-4027

Phone: 404.718.1616

Fax: (404) 639-7090

Email: [email protected]

Table of Contents

1. Respondent Universe and Sampling Methods 3

2. Procedures for the Collection of Information 4

3. Methods to Maximize Response Rates and Deal with Nonresponse 4

4. Tests of Procedures or Methods to be Under-taken 5

5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data 5

B. Collections of Information Employing Statistical Methods

The purpose of this survey is to provide direction for future education and promotion of activities that reduce exposure to ticks for school-aged children and support efforts to control or prevent the transmission of the pathogens that cause Lyme disease, anaplasmosis, and babesiosis.

Collection of information from this survey is not designed or intended to develop incidence or prevalence estimates. This survey is not intended to yield results that are statistically projectable, nationally representative, or that produce precise estimates of population parameters. Information gathered under this gen-IC will not be used for the purpose of substantially informing influential policy decisions.

1. Respondent Universe and Sampling Methods

This project will use jurisdictional contacts for healthcare professionals working in schools (HPWS) to target potential participants in New York State and Maryland. We aim to recruit up to 1317 individuals for this project (up to 659 people per state); this target sample size is based on the assumption of one HPWS per school, 4100 total schools in NY and 2483 total schools in MD, and a 20% estimated response rate. The survey population will consist of all licensed HPWS who provide health services or consultation to student patients in a school setting, currently employed in the states of New York (excluding New York City) or Maryland.

We will recruit among all eligible HPWS employed in the states of Maryland or New York (excluding New York City). A question at the beginning of the survey: “Are you currently employed as a licensed healthcare professional that provides health services or consultation to students in a school setting?” will help to select for the target population. Respondents answering “no” will be terminated from the survey and thanked for their time.

Maryland: A self-administered survey will be sent to the 24 lead school nurse coordinators for public schools. The lead coordinators will disseminate the survey to all local public HPWS in their jurisdictions via email. These lead school nurse coordinators oversee approximately 1,400 public schools in their jurisdictions. After two weeks, an electronic reminder postcard will be disseminated to the school health nurses in their jurisdictions. There are approximately1,000 non-public schools in Maryland, and these schools vary significantly regarding student population size and staffing. These schools will be mailed an invitation letter inviting them to participate in the survey. The letter will include an online link to the survey, and also a paper copy of the survey with an enclosed, pre-addressed envelope for the return of the survey. A telephone number will also be supplied in case a respondent wishes to do it over the telephone. A reminder postcard will be sent to these schools two weeks later, asking them to do the survey if not already completed.

New York state: A self-administered survey will be disseminated to HPWS across the state based on a list of all public, private, charter schools and school-based health centers in NYS that is available through the NYS Education Department. HPWS at 3892 public, private, and charter schools and 97 SBHC in New York State, excluding New York City, will be recruited. Recruitment materials will be sent by traditional mail and email when available. Paper copies of the survey will be included in the recruitment mailing to all schools where no phone number or email was listed in the NYS Education Department database.

2. Procedures for the Collection of Information

The survey invitation (Attachments 3, 5, 10) and web link shared with prospective participants will include:

• Explanation of the purpose of the survey, scope of participant involvement, and voluntary nature of their participation

• A link to the survey (typed link as well as scannable QR code) or a paper copy of the survey with a pre-stamped envelope

• Explanation of the survey expiration date

• Project website (Attachment 13) and EIP site contact information in case of questions

If participants are willing to take the survey, they will type the link given in the invitation letter into their web browser. The beginning of the survey will confirm that the respondent is eligible to take the survey.

The following variables will be collected using the REDCap survey (Attachment 1):

• Demographics ( healthcare licensure, employment type, years of employment as a HPWS, number of school sites, average hours of work per week in a school setting, total number of students served, and type of student population)

• Knowledge, attitudes, and practices regarding TBD

• Practices regarding removal of attached ticksPerceived risk for TBD in the student population

• Level of confidence regarding TBD prevention practices

• Sources of information about TBD

• Knowledge of the NYS Education Department TBD curriculum

List of recruitment materials (attachments):

1. Survey

3. NY survey invitation postcard

4. NY survey invitation flyer for mailing

5. NY survey invitation flyer for email

6. NY survey reminder postcard

7. NY survey reminder flyer for mailing

8. NY survey reminder flyer for email

9. MD survey invitation flyer for mailing

10. MD survey invitation flyer for email

11. MD survey reminder postcard

12. MD survey reminder flyer for email

13. HPWS project website

3. Methods to Maximize Response Rates and Deal with Nonresponse

These surveys will expire within six months from the time participants receive the survey invitation letters. Up to two additional invitations will be made to ask participants to respond to the survey (Attachments 6, 7, 8, 11, 12). After completion of the survey, participants will be presented with a thank you message on their screen within REDCap (Attachment 1). At the conclusion of the survey, participants will be provided with links to CDC and state health department websites for further information on LD and TBD prevention, and an EIP site email address to request to be sent free TBD educational materials. Participants will also be given the opportunity to view an answer sheet to knowledge assessment questions.

4. Tests of Procedures or Methods to be Under-taken

CDC will pilot the survey with nine HPWS to obtain feedback about readability, clarity of information, and any other concerns.

5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

All persons listed below may be involved in design, collection and analysis of proposed data:

Maryland Department of Health Emerging Infections Program (MD EIP)

David Crum, Co-PI/State PH Veterinarian, [email protected]

Patricia Ryan, Emerging Infections Program Director, [email protected]

Heather Rutz, Epidemiologist and TickNET Coordinator, [email protected]

Jeré Hutson, TickNET Epidemiologist

New York State Department of Health Emerging Infections Program (NYS EIP)

Jennifer White, Vectorborne Disease Unit Deputy Director, [email protected]

Bryon Backenson, Director, Vector-borne Disease Unit, [email protected]

Alison Kaufman, Program Research Specialist

Adam Rowe, Research Scientist, [email protected]

Kristen Howard, Graduate Student Assistant, [email protected]

Division of Vector-Borne Diseases, Centers for Disease Control and Prevention:

Alison Hinckley, PhD, Epidemiologist, 970.266.3558, [email protected]

Grace Marx, MD, MPH, Medical Epidemiologist, 970.266.3583, [email protected]

Alyssa Beck, MPH, ORISE Fellow, 970.225.4234, [email protected]

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