PopSurvey_SupportingStatement_A_04-11-2016 CLEAN

PopSurvey_SupportingStatement_A_04-11-2016 CLEAN.docx

FoodNet Population Survey

OMB: 0920-1112

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1112 can be found here:

2018-12-18 - Extension without change of a currently approved collection

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FoodNet Population Survey

Existing Collection In Use Without an OMB Control Number

Supporting Statement – Section A

April 11, 2016

Program Official/Project Officers

Olga Henao, PhD

Division of Foodborne, Waterborne, and Environmental Diseases,

National Center for Emerging and Zoonotic Infectious Diseases,

Centers for Disease Control and Prevention

1600 Clifton Road NE MS C-09, Atlanta, GA30333
Office: (404) 639-3393

Email: [email protected]

Table of Contents

Justification

Circumstances Making the Collection of Information Necessary………..…………….……..……………..……..3
Purpose and Use of the Information Collection………….………………..……..………….………...………..….….….4
Use of Improved Information Technology and Burden Reduction……….………….……….…..…….……..…..5
Efforts to Identify Duplication and Use of Similar Information………………..……….……….…………….………5
Impact on Small Businesses or Other Small Entities……………………………………….…………..………..………..6
Consequences of Collecting the Information Less Frequently……………………….………………………..………6
Special Circumstances Relating to the Guidelines of 5 CFR 1320.5……………….…………………………….…..6
Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency..7
Explanation of Any Payment or Gift to Respondents……………………………………………………………………...7
Assurance of Confidentiality Provided to Respondents………………………………………………….……………….7
Justification for Sensitive Questions……………………………………………………………………………….…………..….8
Estimates of Annualized Burden Hours and Costs………………………………………….……………………………....8
Estimates of Other Total Annual Cost Burden to Respondents or Record Keepers……………….….….….9
Annualized Cost to the Government……………………………………………………………………………...………….…..9
Explanation for Program Changes or Adjustments............................................................................10
Plans for Tabulation and Publication and Project Time Schedule…………………………..……….…………….10
Reason(s) Display of OMB Expiration Date is Inappropriate……………………………….……………..………...11
Exceptions to Certification for Paperwork Reduction Act Submissions…………………..………….………...11

References…………………………………………………………………………………………………………..……….……………………..11

List of Attachments……………………………………………………………………………………………………………………………...13

Shape1

Goals of study
1. Provide necessary data to estimate the burden of unreported and reported acute diarrheal illness in the catchment area, for use in modeling such burden in the United States more broadly.
2. Assess the frequency of important exposures commonly associated with foodborne illnesses in the catchment area, for use in modeling such burden in the United States more broadly.

Intended use of resulting data:
1. Populating models designed to estimate prevalence of diarrheal illnesses in the United States
  - Assess efficacy of interventions implemented to reduce diarrheal diseases
  - Develop metrics for diarrheal disease food safety policies and programs
  - Estimate costs of diarrheal illnesses
  - Inform industry, academic and public health diarrheal disease research and food safety activities
2. To provide estimates of food consumption and other exposures in the catchment area for use to guide generation of hypotheses during outbreak investigations
3. To provide estimates of food consumption and other exposures in the catchment area to assist in the study of factors (e.g. specific foods, routes of exposure, settings, healthcare seeking behavior) associated with sporadic illness
4. To provide data to estimate changes in healthcare seeking behavior and diagnostic testing practices (stool testing) for diarrheal illnesses in the catchment area
Methods for data collection — Multi-mode survey (landline, cell phone, web, mail)
Subpopulation to be studied — Residents of the FoodNet catchment area
How data will be analyzed — Descriptive statistics and regression modeling

Justification

Circumstances Making the Collection of Information Necessary

Background

Foodborne illnesses represent a significant public health burden in the United States. It is estimated that each year, 48 million Americans (1 in 6) become ill, 128,000 are hospitalized, and 3,000 die as the result of a foodborne illness¹. Because foodborne illness poses a substantial public health challenge, food safety has been identified as one of CDC’s ten “winnable battles”, public health priorities with large-scale impact on health and with known, effective strategies to address them (See Attachment C).

The Foodborne Diseases Active Surveillance Network (FoodNet) is the principal foodborne disease component of CDC's Emerging Infections Program (EIP) (OMB: 0920-0978) and a collaborative project of the CDC, ten EIP sites (California, Colorado, Connecticut, Georgia, New York, Maryland, Minnesota, Oregon, Tennessee and New Mexico), the U.S. Department of Agriculture (USDA), and the Food and Drug Administration (FDA). Since 1996, FoodNet has conducted active population-based surveillance for Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli O157 and non-O157, Shigella, Vibrio, and Yersinia infections. The surveillance area includes 15% of the United States population (48 million persons). Data from FoodNet serve as the nation’s “report card” on food safety by monitoring progress toward Healthy People 2020 objectives.

FoodNet determines the incidence of laboratory-confirmed infections for bacterial pathogens transmitted commonly through food. However, these reports represent only a subset of the number of cases of diarrheal illness that occur in the community. Most diarrheal illnesses are undiagnosed and, therefore, not reported. In order for a case of foodborne illness to be reported: the person must become ill, the ill person must seek and have access to medical care, a health care provider must obtain a specimen for microbial analysis from the ill person and submit the specimen to a laboratory, the laboratory must test for the pathogen and identify the pathogen, the laboratory must report the case to the local or state health department, and the case must be reported to CDC. Understanding the degree of underreporting that occurs at each of these steps is a critical piece in understanding the burden of foodborne illness in the surveillance area.

Evaluation of efforts to control foodborne illnesses can only be done effectively if there is an accurate estimate of the total number of illness that occur and if these estimates are recalculated and monitored over time. Estimates of the total burden start with accurate and reliable estimates of the number of acute gastrointestinal illness episodes that occur in the general community. To more precisely estimate the number of acute diarrheal illness and to describe the frequency of important exposures associated with illness, FoodNet created the Population Survey. The methods for this population-based survey of persons residing in the surveillance area is modeled after the BRFSS. Data are collected on the prevalence and severity of acute gastrointestinal illness (AGI) in the general population of the FoodNet geographic areas, describe common symptoms associated with diarrhea, and determine the proportion of persons with diarrhea who seek medical care. The survey also collects data on exposures (e.g. food, water, animal contact) commonly associated with foodborne illness. To date, five 12-month cycles of the survey have been completed: 1996-1997, 1998-1999, 2000-2001, 2002-2003, and 2006-2007. By conducting the Population Survey in the same geographic areas served by FoodNet, it is possible to adjust pathogen-specific incidence of foodborne diseases for underdiagnosis resulting from medical care seeking and specimen submission and to link these data with other relevant information, including hospitalizations, deaths, and history of travel. Because FoodNet conducts surveillance at 10 US sites, these data are further adjusted for geographical coverage (online Technical Appendix).¹

Data from the population survey have multiple uses. Information on AGI and health-seeking and testing behaviors, used in conjunction with foodborne disease surveillance, serve as the foundation of estimates of total number of foodborne illnesses in the United States summarized in publications by Mead et al, in 1999³ and Scallan et al, in 2011¹. Data on food exposures in the general public have proved invaluable to outbreak investigations. The ability to compare exposures reported by outbreak cases to the ‘background’ exposure in the general population allows investigators to more quickly pinpoint a source and enact control measures. More than two dozen manuscripts incorporating population survey data have been published^1,3-24.

This data collection is authorized by Section 301 of the Public Health Service Act (42 U.S.C. 241) (Attachment A).

Purpose and Use of the Information Collection

The objectives of the survey are:

Provide necessary data to estimate the burden of unreported and reported acute diarrheal illness in the catchment area, for use in modeling such burden in the United States more broadly.
Assess the frequency of important exposures commonly associated with foodborne illnesses in the catchment area, for use in modeling such burden in the United States more broadly.

The results of the survey will be used:

To populate CDC’s model designed to update estimates on total number of diarrheal illnesses and foodborne illnesses in the United States.
To provide estimates of food consumption and other exposures for use to guide generation of hypotheses during outbreak investigations.
To provide estimates of food consumption and other exposures to assist in the study of factors associated with sporadic illness.
To provide data to estimate changes in healthcare seeking behavior and diagnostic testing practices (stool testing) for diarrheal illnesses.

The data from this collection are not designed to be nationally representative. Similarities between the US population and the surveillance network with respect to high-level demographic characteristics such as percent of the population that is Caucasian do not address potential relationships between geographic variables, health variables, and demographic characteristics. As such, CDC must always transparently articulate the limitations with respect to generalizability.

De-identified results will be made available in a public use data file. A link to data file will be posted to the CDC FoodNet website shared with participating state health departments and CDC programs, FDA, and USDA.

Use of Improved Information Technology and Burden Reduction

An integrated data collection platform that has been used in numerous surveys and can generate screens adapted for each data collection mode will be used by the contracting agency, ICF.¹ This approach offers several benefits including standardized skip patterns and logic rules, quotas, and databases across multiple modes; more efficient, accurate tracking and reporting across all survey modes; and complete flexibility for respondents (they can complete part of the survey by phone or web, return to the survey at a later time, and seamlessly pick up where they left off).

Hard copy forms will not be used, thereby reducing the time and resources needed for manual data entry. Data will be transmitted to CDC electronically.

Efforts to Identify Duplication and Use of Similar Information

FoodNet is a collaborative program coordinated within the Enteric Disease Epidemiology Branch (EDEB) in the Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) at CDC. EDEB and DFWED are responsible for surveillance and study of foodborne diseases in the United States. FoodNet Population Survey is unique in that within the survey population FoodNet has conducted active surveillance on 9 enteric pathogens, collecting demographic, geographic, testing practices, and outcome data. By pairing the population survey data with active case-based surveillance data collected from these same sentinel sites, we can more efficiently collect data needed to determine burden of disease from individual pathogens that cause foodborne illness.

Exploration of using BRFSS to collect some of this data was explored in 2013 and 2014. We submitted a questionnaire of 10 questions to be voted on for incorporation into the survey. In both years we received feedback from state partners that these questions were not in-line with the objectives of BRFSS as they were not behavioral objectives. BRFSS core survey (conducted on all participants) is a lengthy survey and in order to minimize burden on survey respondents, proposals of adding more than 10 are proposed as “optional” modules (conducted on selected participants). This optional module has to be approved by a minimum 70% of the states. Once approved implementation of the optional module is not mandatory, thus even though you achieved approval and funded for example a 10 question optional module at ($18,000/question), you have no guarantee that states will elect to implement your module. In 2010, BRFSS had 26 optional modules with a median of 5 questions per module. The median number of states that participated in each optional module was 5.0, limiting the ability to apply interpretation of the data obtained on a national level. In 2013, FoodNet staff surveyed state representatives at the BRFSS conference and only a minority of states (n=8) expressed interest in incorporating the module and all stated that it was too long. We submitted the optional module for approval, and only 59% of states voted for it to even be an option. This module would have only provided data for determining the burden of acute intestinal illness and would not have allowed us to achieve our other equally important objectives. In 2007 we were able to incorporate 2 questions into the BRFSS core survey that are included in our current population survey. This will allow for a baseline comparison for future efforts.

Other efforts such as National Health and Nutrition Examination Survey (NHANES) collect food consumption data, however the data collected by these efforts does not meet our needs. For example, NHANES does not meet our needs for 3 main reasons: the exposure history time period (24hrs) and methodology (complete diary) compatible with the exposure history (7-14 days) and methodology (high risk exposures, targeted routes of exposures, balanced questionnaire of all food commodities) used for outbreak investigations and food source attribution. In summary no other groups collect the type and level of detailed information that is proposed in this study.

Impact on Small Businesses or Other Small Entities

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

Consequences of Collecting the Information Less Frequently

The purpose of this survey is to collect data that is not otherwise available. Specifically, without this data there would be:

Inability to provide updated burden of foodborne illness estimates which have been requested by federal regulatory agencies,
Reduced ability to conduct outbreak investigations because of a lack of information on current food consumption practices and other exposures.

There are no legal obstacles to reduce the burden.

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.

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

A 60-day Federal Register Notice will be published in the Federal Register. Comments will be reviewed and incorporated, as appropriate, into the survey protocol and questionnaire.
- The development of this study was a collaborative effort among all agencies in the FoodNet program. The protocol and questionnaire has undergone extensive review and edits over the five cycles of administration. Prior to each cycle of the survey, the Population Survey working group, consisting of representatives from each of the partner agencies, was convened. This group was used to develop the survey content, which was then shared with all members of the FoodNet steering committee (including the FoodNet principal investigators) for approval. Current members of the working group include: (CDC) Allison Brown, Sarah Collier, Cindy Friedman, Katie Fullerton, Aimee Geissler, Laura Gieraltowski, Jennifer Hunter, Olga Henao, Ellyn Marder, Patricia Griffin, Scott Grytdal, Aron Hall, Michele Hlavsa, Mike Hoekstra, Kelly Jackson, Karen Neil, Thai-An Nguyen, Megin Nichols, Elaine Scallan, Robert Tauxe, Antonio Vieira, Matthew Wise, Ian Williams; U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS),) Wu San Chen, Kristin Holt, Janelle Krause, Amelia Kermis, Bonnie Kisler, Davi LaBarre, Maria Malagon; (U.S. Food and Drug Administration (FDA)) Michael Bazaco, Susan Lance, Marguerite Pappaioanou, Cary Parker, Katherine Vierk, Beverly Wolpert; (California Emerging Infections Program) Debra Gilliss, Tanya Libby; (Colorado Department of Public Health and Environment) Elisha Wilson; (Connecticut Department of Public Health) Terry Rabatsky-Ehr, Connecticut Emerging Infections Program) Paula Clogher, Jim Hadler; (Georgia Division of Public Health) Nadine Oosmanally; (Maryland Department of Health and Mental Hygiene) Michelle Boyle, Jordan Cahoon; (Minnesota Department of Health) Amy Saupe; (New Mexico Emerging Infections Program) Sarah Lathrop, Cyndy Nicholson; (New York State Department of Health) Suzanne McGuire, Shelley Zansky;(Oregon Department of Human Services) Paul Cieslak, Beletshachew Shiferaw; (Tennessee Department of Health) Corrine Davis, John Dunn.

Explanation of Any Payment or Gift to Respondents

The contract developed by the survey implementation partner, ICF, includes a $2 to $5 pre-incentive, which has been shown to increase response rates by as much as 20 points. Details of payment to recipients are described in Supporting Statement – Section B.

Assurance of Confidentiality Provided to Respondents

The Privacy Act is not applicable since no identifiable information is being collected.

Individuals asked to provide information for the survey will be informed of the reason for collecting the information and how the information will be used. Participants are informed that study participation is completely voluntary and they may choose to decline study enrollment or to not answer any questions that they consider to be of a sensitive nature. There are no penalties for not participating. Participants may refuse to answer any of the questions or to discontinue the survey at any time. Consent and assent will be documented. All survey data will be kept secure. Names will not be collected. Analysis will be conducted at a summary level.

A statement of how data will handled will be read to each potential participant as part of the process of obtaining informed consent for participation in the study. Only the databases will be forwarded to CDC. Demographic information (e.g. age, sex) will be collected; individual names will not. Each record will be assigned a unique ID. Only summary information will be included in analysis and reports.

This study has been approved by the Institutional Review Board at CDC (Attachment E).

Justification for Sensitive Questions

No information will be collected that are of personal or sensitive nature.

Estimates of Annualized Burden Hours and Costs

Data collection will be for a total of 24 months. For each 12 month period, we anticipate an enrollment of 150 persons per site per month which will result in 18,000 interviews. In addition, there will be pilot interviews with up to 200 people. Each interview will take approximately 20 minutes (or 0.33 hours). This results in a total burden of 6,066 hours for 12 months of data collection, and 12,133 hours for the entire survey period.

Table A.12-1. Estimated Annualized Burden Hours

Type of Respondents

Form Name

No. of Respondents

No. of Responses per Respondent

Avg. Burden per Response (in hrs.)

Total Burden

(in hrs.)

U.S. General Population

Attachment D. Pop Survey_ questionnaire_Feb 2016

18,200

20/60

6,033

Total

6,000

Annualized burden costs are summarized in the table below. These calculations assume the average hourly wage of $24.54 for all jurisdictions included in the FoodNet catchment area. Hourly rates were taken from the most recent publically available Current Employment Statistics of the Bureau of Labor Statistics and are based upon the average hourly earnings for October 2012 from the Current Employment Statistics survey conducted by the Bureau of labor Statistics (available at http://data.bls.gov/cgi-bin/surveymost).

Table A.12-2. Estimated Annualized Burden Costs

Type of Respondents	Form Name	Total Burden Hours	Average Hourly Wage Rate*	Total Cost Burden
U.S. General Population	Attachment D. Pop Survey_IRB approved questionnaire_April 2015	6,033	$24.54	$148,050
Total		6,033	$24.54	$148,050

Estimates of Other Total Annual Cost Burden to Respondents or Record Keepers

There will be no direct costs to the respondents other than their time to participate in each survey.

Annualized Cost to the Government

There are no equipment or overhead costs. The cost to the federal government includes the salary of CDC staff supporting the data collection activities and the money to support the contracting company for survey administration.

CDC staff will work with the contractor to oversee deliverables, obtain study data, and perform analysis. The costs will be spread over a period of four years. Year 1 will include activities such as obtaining OMB approval, working to set up the contract, analyzing feedback from 9 pilot interviews, and making any necessary revisions to the questionnaire. Years 2 and 3 will involve oversight of contractor during data collection, and receipt and analysis of preliminary data. Year 4 will involve analysis of final data and preparation of summary reports. The annualized cost will be $66,250; the total cost over 4 years will be $265,000.

An outside company (to be contracted through CDC) will have the primary responsibility for administration of this survey. In year 1, the contractor will provide expertise in survey design and implementation, work with CDC to define modes of administration, conduct focus testing of questionnaires, conduct pilot testing prior to the start of study, develop sampling weights, and program the survey instruments. The Contractor will also pre-test the questionnaire to assure the programming and questionnaire and skip patterns work properly. Finally, the Contractor will be responsible for obtaining Institutional Review Board (IRB) review and approval prior to data collection, if necessary. In years 2 and 3, the contractor will collect the data, make changes as requested by the client, generate datasets to be used by CDC for analysis, and generate quarterly progress reports. In year 4, the contractor will generate the final dataset for the study per CDC specifications and generate a technical report summarizing the study. The cost of this contract is estimated to be $1,992,848 which will be spread out over 4 years in accordance with the stated deliverables. (Exact costs will not be available until after contractor is selected). Table A.14 shows the average cost for one year. A detailed estimate of costs is found in Attachment F.

The estimated cost to the federal government for one year is $564,462. Table A-14.1 describes how this cost estimate was calculated. Total cost over 4 years (set up, 2 years of data collection, analysis) is $2,257,848 (CDC staff: $265,000; contract: $1,992,848).

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

Staff (FTE)	Average Hours per Collection	Average Hourly Rate	Average Cost
Senior Epidemiologist(GS-13) Work with contractor to finalize development of instrument, pilot testing, renewal of IRB and OMB packages, receive and analyze data	1,000 (20 hours per week for 50 weeks/year)	$41.93	$41,930
Surveillance Epidemiologist (GS-9) Assist with data analysis and report preparation	1,000 (20 hours per week for 50 weeks/year)	$24.32	$24,320
Contract (1 year)			$498, 212
Estimated Total Cost of Information Collection			$564,462

Explanation for Program Changes or Adjustments

Although 5 cycles of the FoodNet population survey have been conducted, this request is the first for OMB. Initial burden estimates are based on responses from the 2006-2007 survey. CDC will use the Change Request mechanism to provide updates on any changes to the content of the survey for 2015-2016 and estimated burden per response.

Plans for Tabulation and Publication and Project Time Schedule

The results of the survey will be shared with participating state health departments and CDC programs, available for public release through a summary report, and posted to the FoodNet website.

Analysis Plan

Preliminary data analysis will begin upon receipt of the first dataset from the contracting company (estimated to be one month after completion of the first 3 months of interviews) and continue with each subsequent dataset. Final analysis will be conducted after receipt of the final study dataset containing information from the full 24 months. CDC staff will perform analysis using SAS v9.3. The analysis will consist of descriptive statistics and regression modeling, as appropriate.

Project Time Schedule

Design survey questionnaire (COMPLETE)

Receive IRB approval (COMPLETE)
Prepare the request for task order proposal form (COMPLETE)

Prepare OMB package (COMPLETE)
Submit OMB package (COMPLETE)

OMB approval (TBD)
Publish RFP, receive bids, and select contractor (COMPLETE)
Pilot test survey questionnaire (1 month)
Conduct survey (24 months)
Collect, code, quality control, and analyze data (3 months)
Prepare summary reports (3 months)
Disseminate results/publication of findings 3 months)

Reason(s) Display of OMB Expiration Date is Inappropriate

We are requesting no exemption.

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.

References

Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson M-A, Roy SL, Jones JL, Griffin PM: Foodborne illness acquired in the United States—Major Pathogens. Emerg Infect Dis 2011, 17:7-15.
CDC. Behavioral Risk Factor Surveillance System (BRFSS) Overview 2013. http://www.cdc.gov/brfss/annual_data/2013/pdf/overview_2013.pdf. Accessed April 21, 2015.
Mead PS¹, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV. Food-related illness and death in the United States. Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25.
Ahmad N, Karr J, Smith G, Burzlaff K, Nguyen T, Gieraltowski L, et al. Rapid response to Escherichia coli O157 outbreak – New York, 2012. In: Proceedings of the 62nd Annual Epidemic Intelligence Service (EIS) Conference; 2013 Apr 22-26; Atlanta, GA. Poster 2.12.
Ailes E, Scallan E, Berkelman R, Kleinbaum D, Tauxe R, Moe C. Do Differences in Risk Factors, Medical Care Seeking, or Medical Practices Explain the Geographic Variation in Campylobacteriosis in the FoodNet Sites?
Abrams JY, Maddox RA, Harvey AR, Schonberger LB, Belay ED. Travel history, hunting, and venison consumption related to prion disease exposure, 2006-2007 FoodNet Population Survey. J Am Diet Assoc. 2011 Jun; 111(6):858-63.
Buzby JC, Gould LH, Kendall ME, Jones TF, Robinson T, Blayney DP. Characteristics of consumers of unpasteurized milk in the United States. J Consum Aff. 2013 Jan; 47(1):153-66.
Cantwell LB, Henao OL, Hoekstra RM, Scallan E. The effect of different recall periods on estimates of acute gastroenteritis in the United States, FoodNet Population Survey 2006–2007. Foodborne Pathog Dis. 2010 Oct;7(10):1225-8
Gieraltowski L, Julian E, Pringle J, Macdonald K, Quilliam D, Marsden-Haug N, et al. Nationwide outbreak of Salmonella Montevideo infections associated with contaminated imported black and red pepper: warehouse membership cards provide critical clues to identify the source. Epidemiol Infect. 2013; 141(6):1244-52.
Green LR, Selman C, Scallan E, Jones TF, Marcus R, and the FoodNet Population Survey Working Group. Beliefs about meals eaten outside the home as sources of gastrointestinal illness. J Food Prot. 2005;68(10);2184–2189.
Hale CR, Scallan E, Cronquist AB, Dunn J, Smith K, Robinson T, et al. Estimates of enteric illness attributable to contact with animals and their environments in the United States. Clin Infect Dis. 2012; 54(Suppl 5):S472–9.
Hancock WT, DeSalvo T, Gaul L, Hanson H, Schoonmaker-Bopp D, Vostok J, et al. A spicy catch: Salmonella Bareilly and Salmonella Nchanga infections associated with a raw scraped ground tuna product – United States, 2012. In: Proceedings of the 62nd Annual Epidemic Intelligence Service (EIS) Conference; 2013 Apr 22-26; Atlanta, GA. Poster 1.15.
Hoefer D, Malone S, Marcus R, Frenzen PD, Scallan E, Zansky SM. Knowledge, attitude, and practice of the use of irradiation among respondents to the FoodNet Population Survey in Connecticut and New York. J Food Prot. 2006;69(10):2441–2446.
Imhoff B, Morse D, Shiferaw B, Hawkins M, Vugia D, Lance-Parker S, Hadler J, Medus C, Kennedy M, Moore MR, Van Gilder T. Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998-1999. Clin Infect Dis. 2004;38(Suppl 3):S219-226.
Kendall ME, Scallan E, Greene SA, Ryan P, Robinson T, Shiferaw B, et al. Differences by age group in the prevalence of diarrhea and vomiting, rates of seeking health care, and stool sample submission: FoodNet Population Survey, 1996-2007. In: Proceedings of the International Conference on Emerging Infectious Diseases; 2012 Mar 11-14; Atlanta, GA. Abstract 361.
Patrick ME, Griffin PM, Voetsch AC, Mead PS. Effectiveness of recall notification: community response to a nationwide recall of hot dogs and deli meats. J Food Prot. 2007 Oct;70(10):2373-6.
Samuel MC, Vugia DJ, Koehler KM, Marcus R, Deneen VC, Damaske B, Shiferaw B, Hadler JL, Henao OL, Angulo FJ. Consumption of risky foods Among adults at high risk for severe foodborne diseases: Room for improved targeted prevention messages. J Food Saf 2007;27(2):219-232.
Scallan E, Majowicz SE, Hall G, Banerjee A, Bowman CL, Daly L, Jones T, Kirk MD, Fitzgerald M, and Angulo FJ. Prevalence of diarrhoea in the community in Australia, Canada, Ireland, and the United States. Int J of Epidemiol. 2005;34(2):454–460.
Scallan E, Jones TF, Cronquist AB, et al. Factors associated with seeking medical care and submitting a stool sample in estimating the burden of foodborne Illness. Foodborne Pathog Dis. 2006;3(4):432–438.
Patrick ME, Mahon BE, Zansky SM, Hurd S, Scallan E. Riding in shopping carts and exposure to raw meat and poultry products: prevalence of, and factors associated with, this risk factor for Salmonella and Campylobacter infection in children younger than 3 years. J Food Prot.2010 Jun;73(6):1097-100.
Shiferaw B, Verrill L, Booth H,. Zansky S, Norton D, Crim S, Henao O. Sex-Based Differences in Food Consumption: Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey, 2006–2007. Clin Infect Dis. 2012 Jun;54 Suppl 5:S453-7.
Slayton RB, Turabelidze G, Bennett SD, Schwensohn CA, Yaffee AQ, Khan F, et al. Outbreak of Shiga toxin producing Escherichia coli (STEC) O157:H7 associated with romaine lettuce consumption, 2011. PLoS One. 2013; 8(2):e55300.
Taylor EV, Holt KG, Mahon BE, Ayers T, Norton D, Gould LH. Ground Beef Consumption Patterns in the United States,

FoodNet, 2006 through 2007. J Food Prot. 2012; 75(2):341-346.

Vanden Eng J, Marcus R, Hadler JL, et al. Consumer attitudes and use of antibiotics. Emerg Infect Dis. 2003; 9(9): 1128-1135.

List of Attachments

Note: Attachments are included as separate files as instructed.

Attachment A: Authorizing Legislation
Attachment B: Federal register 60 day notice
Attachment C: Winnable Battles Letter from CDC Director on Food Safety
Attachment D: Pop Survey Cleared Questionnaire February 2016
Attachment E. Protocol 1546 CDC Continuation Approval
Attachment F: APHIR IGCE FoodNet Population Survey RFTOP v2

1 http://www.cdc.gov/foodborneburden/resources.html

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