Request for Approval under the “Generic Clearance for the Collection (OMB Control Number: 0920-1154)

Request for genIC Approval

CDC/ATSDR Formative Research and Tool Development

0920-1154

CIO: National Center for Emerging and Zoonotic Infectious Diseases

PROJECT TITLE: Creative Concept Testing on Antimicrobial Resistance

PURPOSE AND USE OF COLLECTION: The Centers for Disease Control and Prevention (CDC) is requesting approval for a new generic information collection (gen-IC). The purpose of this data collection is to assess a set of four creative concepts for each of two audiences and inform the optimal creative approach for a potential future CDC communications campaign about antimicrobial resistance (AR). Findings will be used to identify and optimize the creative approach that most clearly articulates the problem of AR and most effectively conveys the importance of individual action to prevent the spread of infections.

DESCRIPTION OF RESPONDENTS: There are two core audiences: human healthcare professionals (physicians, physician associates/assistants, nurse practitioners) and consumers (adults and parents of young children).

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. Information gathered will not be used to substantially inform influential policy decisions.

5. The study is not intended to produce results that can be generalized beyond its scope.

Name: Mike Ruddell, Vice President, KRC Research

To assist review, please answer the following questions:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [X] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [X] Yes [ ] No

Focus group and interview participants will receive a monetary incentive of $75 for their participation. Incentive amounts are determined based on a variety of factors including the time that a respondent will dedicate to the response, the difficulty of reaching a given profile of respondent, and the urgency of the response. Such an incentive is a standard practice in the market research industry and helps to ensure efficient recruitment and ultimate participation among the qualified and scheduled participants. The incentive is also intended to offset the cost of personal or professional time taken to participate.

BURDEN HOURS

Form Name	Type of Respondent	No. of Respondents	No. Responses per Respondent	Avg. Burden per response (in hrs.)	Total Burden (in hrs.)
Screener Attachment 1	Consumers	480	1	5/60	40
Screener Attachment 2	Physicians	40	1	5/60	3
	Physician Associates/Assistants	20	1	5/60	2
	Nurse Practitioners	20	1	5/60	2
Discussion Guide Attachment 5	Consumers	48	1	1.5	72
Discussion Guide Attachment 6	Physicians	4	1	1	4
	Physician Associates/Assistants	2	1	1	2
	Nurse Practitioners	2	1	1	2
Total					127

FEDERAL COST: The estimated annual cost to the Federal government is $171,308.24.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

See Section 1 in Supporting Statement B for a full description of the sampling plan.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [X] Yes [ ] No

Please make sure all instruments, instructions, and scripts are submitted with the request.

Instructions for completing genIC Request for Approval for

CDC/ATSDR Formative Research and Tool Development

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is requested.

PURPOSE and USE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Briefly describe the targeted group/groups for this collection.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

Form: Provide the title of the information collection form.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group).

Burden in Minutes: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Estimate the annual cost to the Federal government for this collection.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

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