HMTS Expedited Review Form

Health Message Testing System Expedited Review Form
1. Title of Study: (Please append screener and questionnaire)

CDC Older Adult Injury Prevention Creative Campaign Survey

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

Adults aged 65 and older who live in the following states: Arkansas, Maine, Oklahoma, Oregon,
Wisconsin. Respondents will be recruited through SurveyMonkey's online panel audience.

Respondent characteristics:
Number of subject: 500

Number of males:

250

Age range: 65 and older

Number of females: 250

Racial/ethnic composition: Mix of racial backgrounds
Special group status: (e.g., risk group, health care providers)
Type of group(s): Adults
Geographic location(s): The following states in the United States - Arkansas, Maine,
Oklahoma, Oregon, Wisconsin
3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

The Federal government will not directly pay incentives to the survey participants. Participants to the
survey are already registered with an online panel provider (SurveyMonkey) and will be offered survey
choice “points” to redeem for prizes (values less than $1) which are commonly provided to survey panel
respondents who complete online surveys. The points will not be sent to respondents from CDC, but
instead will be provided by SurveyMonkey to respondents who complete the survey.

4. Study method: (Please check one below)
Central location intercept interview:
Online Interview:
Telephone interview:

Focus group:
Individual in-depth interview (cognitive interview):

(CATI used: yes or no): No

Other (describe): Online (or Web-based) survey

5. Purpose of the overall communication effort into which this health message(s) will fit:
(Please provide 2-3 sentences below.)

CDC requests OMB approval to collect information related to the Older Adult Injury Prevention
awareness and knowledge building campaign, including the perception and effectiveness of campaign
messages to (1) ensure the campaign meets the needs of target audiences; (2) assess awareness, perception
of knowledge, and attitudes about campaign messages; and (3) intentions to engage in campaign promoted
behaviors.
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.)
Adults aged 65+ experience an increased risk of injury, especially from falls and motor vehicle crashes,
which can lead to a loss of independence and mobility, increasing social isolation, and depression. Such
injuries cost the healthcare system billions of dollars annually. A CDC study found that in 2015, total
medical costs to treat older adult falls exceeded $50 billion. Older adults are projected to be 23.5% of the
total US population by 2060, so it is imperative to reduce these sources of unintentional injury.

8. Number of burden hours requested: 83

BURDEN HOURS
No. of
Participation
Respondents Time

Category of Respondent
Adults 65 and older - CDC Older Adult Injury Prevention Creative Campaign Survey

500

Totals

500

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

10/60

Burden
83.3

83

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: 3255
2. OADC confirmation of time-sensitivity:
Yes:
No:

Dawn B. Griffin
Project Officer
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