SupSta B

Generic Clearance for CDC/ATSDR

"Participatory Mapping to Identify and Support at-Risk Populations in Emergency Preparedness" – Phase 2

OMB Control No. 0920-1154

Supporting Statement B

July 23, 2018

CDC Contact:

Tracy N. Thomas, MSc, MPH

Senior Health Scientist

Office of Public Health Preparedness and Response (OPHPR)

Centers for Disease Control and Prevention

1600 Clifton Rd NE MS K72

Atlanta, GA 30333

Tel: 770-488-1570

BB: 404-772-1447

Email: [email protected]

Telework: Tuesdays and Fridays

Table of Contents

Collection of Information employing Statistical Methods

1. Respondent Universe and Sampling Methods

2. Procedures for the Collection of Information

3. Methods to Maximize Response Rates and Deal with Non response

4. Tests of Procedures or Methods to be Undertaken

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

B. Collections of Information Employing Statistical Methods

1. Respondent Universe and Sampling Methods

Non-probability convenience sampling will be used to identify community leaders from multiple organizations, as well as from the network of private citizens or residents engaged in community activities, to participate in the survey. From these initial contacts, snowballing will be used to identify additional interviewees. Sample size will be based on reaching theoretical thematic saturation during the analysis, where new data confirms the analysis and no longer offers any new information. We estimate that one group interview with 15 participants in each of the five communities will be conducted for a total of 75 interviewees will be conducted in Year 2 (July, 2018 – September, 2018).

2. Procedures for the Collection of Information

In this project, the staff from Harvard T.H. Chan School of Public Health will conduct group interviews for community leaders through five collaborating community-based organizations (CBOs) about their first-hand knowledge of emergency preparedness needs at the community level. The collaborating CBOs include Santa Rosa County (Florida), San Juan (Puerto Rico), Charleston-Kanawha County (West Virginia), Boston (Massachusetts), and Brockton (Massachusetts).

The Harvard research team has pre-existing partnerships with these organizations which serve at-risk populations through a wide range of public health emergencies due to their geographic locations (i.e. Zika in Puerto Rico, snow storms in Massachusetts, hurricanes in Florida, water contaminations in West Virginia). For example, the Cape Verdean Association in the city of Brockton, MA would help to identify specific vulnerabilities within the Cape Verdean community. In Jamaica Plain in Boston, MA, the Somali Development Center would help to identify specific vulnerabilities within the Muslim Community. In Santa Rosa County, FL and San Juan, Puerto Rico, the Medical Reserve Corps units and faith-based organizations would help to identify specific vulnerabilities in the Latino community, with the unique added opportunity to gather such information in the context of the current response to the Zika outbreak. In Charleston, WV the Charleston Area Medical Center (CAMC) Institute would help focus on the needs of people with addictive disorders.

CBOs will identify the community leaders to participate as survey respondents. Structured qualitative interviews would be conducted to elicit available assets in the community and effective methods to identify vulnerable and at-risk populations, in order to develop a list of strategies for addressing population needs in preparation and response to an emergency. A detailed interview guide has been developed for this purpose, which focuses on areas like personal preparedness, evacuation and access to a shelter, communication, trust and compliance

We estimate that one group interview with 15 participants in each of the five communities will be conducted for a total of 75 interviewees will be conducted in Year 2 (July, 2018 – September, 2018). The group interview is expected to last approximately 90 minutes, and will be organized as follows:

• Welcome and introductions (10 minutes)

• Distribute paper survey and provide overview (5 minutes)

• Walk-through the 49 survey items, reading each data item aloud. We will then (1) ask interviewees to provide verbal feedback on the data item format and content (“What do you think of this question?”, (2) rate their ability in having the knowledge to accurately answer the data item, (3) actually complete the data item question using a ball point pen on the paper survey (45 minutes total, with estimate of 1 minute per data item)

• Present mobile platform survey and ask participants to provide verbal feedback on readability and ease of use (user experience of scrolling, split screens, graphic design) (25 minutes)

• Collect completed paper surveys. Wrap up and thanks (5 minutes)

3. Methods to Maximize Response Rates and Deal with No Response

The Harvard T.H. Chan School of Public Health research group has sub-contracts with the participating CBOs, who will assist the Harvard Chan team in developing a list of community leaders to target for participating in structured, qualitative interviews lasting approximately two hours. An interviewer familiar with the community represented by the CBO will be selected jointly by the Harvard Chan team and CBO to assure cultural sensitivity. A $30 incentive per person will be provided to participants attending the group interview.

The use of strategies, including convenience sampling of referrals made by community leaders, use of a community representative during the interview for cultural sensitivity, and allowing for the provision of a modest incentive are effective strategies for maximizing response rates. Additionally, developing an interview guide focused on community efforts that excludes the collection of personal identifiable and sensitive information will significantly minimize non-responses among interviewees.

4. Test of Procedures or Methods to Be Undertaken

This second interview guide was informed using results from the first data collection instrument. Additionally, T.H. Chan staff consulted with the CBO partners for their subject matter expertise.

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

The data collected will be qualitative in nature, and analyzed by the team members at the Harvard T.H. Chan School of Public Health. However, staff from OPSPH will provide substantial technical assistance and oversight in the analysis and interpretation of the results.

The project is designed to learn about the respondent's community through asking questions on geographic area, socio-economic status, educational levels, general health, key cultural aspect and values. This descriptive insight will help in better analyzing and interpreting the actual interview data and formulating the list of strategies for the community.

The interview questionnaire is based on few pre-identified thematic areas (from both the previous interview results and also a literature review): communication, evacuation and access to a shelter, cultural values, and trust. Further thematic areas may be identified after analyzing the data. This thematic analysis will be conducted independently by at least two researchers and cross-checked for consistency. Disagreements will be resolved through consultations. The Nvivo 11 software would be used.

The findings from this analysis will be shared with the participating CBOs and community leaders, but will not be generalized beyond the scope of each study site or to broader populations.

Finally, it is anticipated the findings will supports efforts of the Office of Sciene and Public Health Practice (OSPHP) in the Office of Public Health Preparedness and Response (OPHPR) to increase capacity to identify vulnerable populations and to advocate for their unique needs. Additionally, this work will add to OSPHP's broad project portfolio to identify evidence-based interventions to mitigate adverse impacts on at-risk populations and identify information needs and optimal communication channels for reaching at-risk populations during emergencies. Moreover, findings from this project will provide CDC with the opportunity to leverage the science and innovations resulting from this effort to substantially contribute to CDC’s improved efficiencies and effectiveness in emergency preparedness and response.

5