HMTS Expedited Review Form GAOS

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

Assessment for the Get Ahead of Sepsis Consumer Campaign

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

CDC is conducting an assessment in Chicago, IL with 4 consumer audiences, recruited via online panel
provider: (1) healthy adults 65+, (2) women who care for a child ≤ 12 years, (3) women who care for an
elderly adult 65+, and (4) men 65+ with 1 or more chronic conditions. See Attachment A for more detail.
Respondent characteristics:
Number of subject: 360

Number of males:

135

Age range: 18+

Number of females: 225

Racial/ethnic composition: n/a for all audiences
Special group status: (e.g., risk group, health care providers)
Type of group(s): 1) healthy adults 65+, (2) women caring for child ≤ 12 yrs, (3)
women caring for adult 65+, (4) men 65+ with chronic conditions
Geographic location(s): Chicago, IL

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

There is no incentive offered for participation in this study.

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):

Other (describe): Online pre- and post-test surveys

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

The GAOS educational effort seeks to prevent and reduce infections that lead to sepsis and optimize
healthcare quality and patient safety by raising awareness, knowledge, and motivating behavior change
related to sepsis prevention, early recognition, and appropriate treatment among 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.)
Sepsis is a complication caused by the body’s overwhelming and life-threatening response to infection,
which can lead to tissue damage, organ failure, and death. More than 1.7 million adults in America
develop sepsis, and nearly 270,000 Americans die as a result of sepsis each year. Public education is
needed to increase awareness and knowledge related to the prevention, recognition, and treatment of
sepsis.

8. Number of burden hours requested: 90

BURDEN HOURS
No. of
Participation
Respondents Time

Category of Respondent
Individuals recruited via online panel providers

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

Burden

360

15/60

90

360

15/60

90

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)
n/a

*** Items below to be completed by Office of Associate Director for Communication (OADC)***
1. Number of burden hours remaining in current year's allocation: 4675
2. OADC confirmation of time-sensitivity:
Yes:
No:

Dawn B. Griffin
Project Officer
Print Form