HMTS Project Template

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

Message and material testing for the Be Antibiotics Aware (BAA) campaign for healthcare providers
(HCPs). The other BAA HMTS package is distinctly aimed at testing material for consumer audiences.
2. Study Population: (Discuss study population and explain how they will be selected/recruited.)

1) Hospitalists, 2) advanced practice providers and physicians in nursing homes (NHs), 3) NH nurses, 4)
dentists, and 5) community pharmacists. Professional recruitment firms will contact individuals, and use
screeners to determine eligibility, availability, and interest. See attachment A for more detail.
Respondent characteristics:
Number of subject: 45

Number of males:

15-30

Age range: 18 years or older

Number of females: 15-30

Racial/ethnic composition: n/a; recruitment firm will attempt a mix of race/ethnicity
Special group status: (e.g., risk group, health care providers)
Type of group(s): Health care providers.
Geographic location(s): AL, AR, IA, KY, LA, MS, MO, NE, TN, WV

3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

Nurses (RNs), nurse practitioners (NPs), physician assistants (PAs), and community pharmacists will
receive a $75 gift card (or cash) for their participation, and physicians (MD/DOs) and dentists (DMD/
DDS) will receive a $125 gift card (or cash). The incentive is based on their participation in a 60-minute
online interview as well as time to review/sign the informed consent form prior to participation. This token
will help offset any costs that the individual may incur to participate. See attachment B for more details.

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

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

(CATI used: yes or no):

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

The Be Antibiotics Aware campaign seeks to optimize antibiotic prescribing and use, in order to improve
patient safety and combat antibiotic resistance, by raising knowledge, increasing awareness and motivating
behavior change (e.g., appropriate prescribing and communication with patients) among HCP and
consumer target audiences.

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.)
Each year in the US, 2 million people become infected with antibiotic-resistant bacteria and at least 23,000
of these individuals die as a result of their infections (CDC, 2013). Many bacteria have become resistant to
more than one type or class of antibiotic. Inappropriate use and misuse of antibiotics fuel resistance that
compromises the effectiveness of these drugs for future use. HCP education is needed to increase
awareness and understanding of appropriate antibiotic practices and consequences of misuse.

8. Number of burden hours requested: 63 hours 45 min.

BURDEN HOURS
Category of Respondent

No. of
Participation
Respondents Time

Burden

Potential respondents (estimate)

225

5 min

1,125 min

HCP interview participants

45

60 min

2,700min

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

225

3,825 min

Yes

If yes, please list the item number(s) for questions used from the question bank separated by a comma.
(e.g., 1a, 3c, 130d)
16c, 6d, 29d, 44d, 64d, 67d, 69d, 110d, 120d, 6e, 7e, 9e, 18e, 65e, 66e

*** Items below to be completed by Office of Associate Director for Communication (OADC)***
1. Number of burden hours remaining in current year's allocation:
2. OADC confirmation of time-sensitivity:
Yes:
No:

Project Officer
Print Form