#17_Justif memo & Attach 17A and17 B_CIS_7-27-2011

Date: July 25, 2011

To: Office of Management and Budget (OMB)

Through: Mary Forbes, Report Clearance Officer, HHS

Seleda Perryman, Project Clearance Officer, OPERA, NIH

Vivian Horovitch-Kelley, NCI OMB Project Clearance Liaison, OMAA

From: Nina Goodman, Acting Associate Director, Project Officer,

Office of Market Research and Evaluation, OCE,

National Cancer Institute/National Institute of Health

Mary Anne Bright, Associate Director,

Office of Public Information and Resource Management, OCE,

National Cancer Institute/National Institute of Health

Subject: Generic Sub-study, “Collection of Data from NCI’s Cancer Information Service (CIS) Website Clients via E-mail Contact Form” under “Formative Research, Pretesting, and Customer Satisfaction of NCI’s Office of Communications and Education,”

(OMB No. 0925-0046-17; Expiration Date 02/13/2013)

Background, Need and Use of Information

The NCI Office of Communication and Education (OCE) advances the mission of NCI by disseminating research results to the public to improve the lives of those affected by cancer. Working closely with scientists and partners, OCE uses effective methods to reach diverse audiences and meet their needs for the latest, evidence-based cancer information. OCE audiences include consumers, researchers, healthcare providers, advocates, media, students, and policymakers.

The official NCI website, www.cancer.gov, is one such method that OCE uses to broaden its reach across a wide variety of public audiences. The website receives more than two million visits and between six to seven million page views every month. Another method is the NCI’s Cancer Information Service (CIS) (OMB No. 0925-0208, Expiration Date 8/31/2012). CIS responds to cancer-related questions from patients, their families and friends, the general public and health professionals through a variety of communications channels. These include telephone, email, and live chat through NCI’s web site. E-mail is particularly challenging because the current online e-mail contact form provides little direction or assessment of a situation. The form solicits just three pieces of information: the e-mail subject of inquiry, the body of the e-mail including the requested information by the client, and the client’s e-mail address. Because the current form asks for minimal information, e-mails are often vague and responses hard to tailor. Omission of certain key facts hinders CIS staff’s ability to provide medically relevant information; for example, if a client types “I need information about breast cancer,” the request contains no context as to whether this is a patient, friend, family, or member of the public. It also does not address the cancer situation making it difficult to tailor a response and thus satisfy the information needs of the requester. Another example of an inquiry might be if a client asks how cancer is diagnosed and they identify themselves as a patient, we might suggest questions they could ask their physician that could both foster the doctor-patient relationship as well as give the patient tools that could be effective in gathering the information they need. More specific information about the client would prevent CIS staff from trying to guess what clients are asking, and waste time researching and responding to unclear and/or incomplete questions that may or may not fully convey the extent of clients’ needs. The time spent attempting to understand a client’s question would be more efficiently spent if the e-mail contact form requested more specific information from the start.

In this regard, OCE seeks to test a new e-mail contact form that solicits more detailed information from website users. A more comprehensive form would allow CIS responders to tailor their answers more specifically to clients’ individual needs and ultimately facilitate more efficient interaction with the public. A number of government agencies are using email intake forms to best meet the needs of their users. Such a form demonstrates practical utility to the Government by limiting duplicitous questions and answers, helping to ensure swift delivery of answers to often time-sensitive inquiries, and taking full advantage of the limited time available to CIS staff to serve the greatest number of clients possible. It would also give NCI valuable data on “the pulse of the public” of the types of information needs they have and inform how best we might inform not only responses but also the development of our public education materials based on this data. Furthermore, more productive exchanges between NCI staff and the public would solidify NCI’s reputation as a high performing organization that is a trusted and valuable source of accurate, scientifically based cancer information.

The Canadian Cancer Society has been using a similar form for several years. Rather than recreate a form, we have selected certain features of Canada’s email form. On its form, the nonprofit asks for specific pieces of information to more expeditiously disseminate information to its clients.

To test usability of the new e-mail contact form, OCE will seek feedback from 200 persons. Staff will collect general commentary from these individuals. The responses garnered will be invaluable to the creation of a more tailored e-mail contact form. Feedback from testers will be reviewed by NCI staff in OCE and will be utilized to adapt the form.

Participants

Patients, their families and friends and the general public will participate in review of the form and will provide feedback. This is based on all email data from 2010 that indicated the following demographics of E-mail users (Attachment 17A): Patients – 15%; Spouse, Relative, or Friend of a Diagnosed Cancer Patient - 33.6%; General Public - 27.9 %

• General commentary will be collected from 200 individuals

• A brief set of questions will be provided for the 200 individuals to respond to on a voluntary basis

Research Instrument

The attached draft e-mail contact form will be used as the research instrument (Attachment 17C). As the draft form currently stands, it will collect email address, client type, type of cancer-related question, zip code, and country

Methodology

On the NCI home page of www.cancer.gov are two text boxes called “Questions About Cancer” at the top and bottom of the page. Clicking on the text box brings users to a “Contact Us For Help” landing page that lists four ways of reaching information specialists at the CIS (Attachment 17B). We propose adding to the paragraph titled “E-mail.” “Help us evaluate a new e-mail form”. The user would click on the associated link that would take them to the draft form and a short set of questions. User review would be completely voluntary (Attachment 17D).

Questions to be located at the end of the draft new e-mail form:

1. Are these questions what you would expect in order to get a complete cancer-related response?

2. Do the questions solicit the most relevant information to in order to receive a satisfying response?

3. What is your preferred way of receiving information?

1. Phone

2. Email

3. Live Chat

4. Social media

4. Do you find these questions burdensome or invasive?

5. Please include any additional comments or suggestions.

“Help us evaluate a new e-mail form” could be promoted through several channels: NCI’s biweekly NCI Cancer Bulletin on-line newsletter; through the Office of Advocacy relations who communicates regularly with the cancer advocacy community; and through the CIS following their tailored email response during usual service. The CIS would respond to the original email inquiry then send a second email letting the individual know that we are soliciting feedback on a new e-mail contact form.

This would be a one-time collection and would not include remuneration for completing the brief survey.

Analysis of the responses to the questions will be qualitative. We are interested in feedback as to whether user believes the E-mail intake form will help NCI provide a more tailored response to the individual thus meeting their information needs. Currently in some cases, when very little information is provided by the individual, NCI is unable to provide a response.

Other Considerations

The Office of Human Subjects Research (OHSR) will be asked to review for this proposal for OHSR exemption or IRB approval. The NIH Privacy Act Officer, will be asked to review the sub-study for PII and Privacy Act applicability.

Both the email form and the survey (Attachments 17C and 17D) should take each of the participants no more than 10 minutes to complete.

Estimates of Hour Burden and Respondent Cost
Types of Respondents	Number of Respondents	Frequency of Response	Average Time Per Response Minutes/Hours	Total Hour Burden
Patients, friends, family, general public	200	1	10/60 (0.167)	33 hrs

List of Attachments (below)

17A. 2010 e-mail contact demographic data

17B. Screen shot of NCI Contact Us Page

List of Attachments (in separate file)

17C. New E-mail contact form

17D. Survey questions about the new e-mail contact form

ATTACHMENT 17A

2010 E-MAIL CONTACT DEMOGRAPHIC DATA

CIS Contact Record Form Data Analysis, Email Point of Contact,

January - December 2010

National Total

Type of User, collapsed codes

• Patient (N 1,191) ; 15.0 %

• Spouse, Relative, or Friend of a Diagnosed Cancer Patient (N 2,670); 33.6%

• General Public (N 2,217) ; 27.9 %

• Organization (N 341) ; 4.3 %

• Professionals (N 715) ; 9.0 %

• Not Able To Ascertain (N 803); 10.1 %

• Total N 7,937

ATTACHMENT 17B

SCREEN SHOT OF NCI CONTACT US PAGE

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