Evaluation of the TravAlert Electronic Messaging System

Evaluation of the TravAlert Electronic Messaging System

Quarantine and Border Health Services Branch
Division of Global Migration and Quarantine
Centers for Disease Control and Prevention

Investigators
Principal Investigators and/or Principal Co-Investigators:
Blanche C. Collins, DGMQ, QBHSB, Communications, Preparedness, Response and
Training Team (CPR-T)
Co-Investigators - CDC:
Terrence Daley, DGMQ, Atlanta Quarantine Station
Susan Dwyer, DGMQ, San Francisco Quarantine Station
Noemi Guzman, DGMQ, Honolulu Quarantine Station
Jorge (Miguel) Ocana, DGMQ, Washington, DC, Quarantine Station
Kirsten Warwar, DGMQ, Miami Quarantine Station
Lee Smith, DGMQ, QBHSB, CPR-T
Co-Investigators – Oak Ridge Institute for Science and Education
Julie Crumly
Ben Wilburn

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Background
Increasing travel across the world has placed individuals at higher risk of acquiring and spreading
disease, including measles. Travelers can be exposed to measles in the country that they are traveling
in or while they are in airports or on airplanes traveling to and from that country1. Between January
and July 2011, the number of reported measles cases imported to the United States was the highest
reported since 1996 with the majority of these cases being among those who had not been
vaccinated for measles and had traveled internationally2.
In countries like the U.S. where measles has been eliminated, imported measles cases are of great
concern since some subpopulations may not be adequately immunized3, 4. If the virus was
introduced, such subpopulations would be at risk of a measles outbreak5.
During an international outbreak, travelers arriving from affected areas pose a risk for introduction
and spread of disease within the United States. Educating arriving international travelers on
recognizing signs and symptoms of the disease and steps to take if such signs and symptoms
develop is imperative in helping to prevent the spread and transmission of disease. Since these
travelers are likely to travel again in the future, they are also an essential audience for messaging on
pre-travel preventive measures such as vaccination.
The Division of Global Migration and Quarantine (DGMQ) Quarantine and Border Health Services
Branch (QBHSB) provides health messaging to arriving international travelers at U.S. Ports of Entry
(POE) during outbreak situations in order to help prevent the transmission of communicable
diseases among international travelers arriving in the U.S.
Messaging to arriving international travelers has traditionally been provided through posters placed
at POE and paper Travel Health Alert Notices (T-HANS) distributed directly to travelers. The use
of printed messaging is slow and expensive, with the result that messages cannot be easily changed
as situations evolve. Distribution of T-HANs is also labor intensive and cannot be effectively
accomplished by quarantine stations staff alone due to their limited personnel at selected POE, thus
requiring collaboration with federal partners such as Customs and Border Protection (CBP) whose
officers are present at all POE and interact with all arriving travelers6.

1

CDC. (2011). Measles Imported by Returning U.S. Travelers Aged 6--23 Months, 2001—2011. MMWR, 60(13);397-400 
(2011). Measles—United States, January–May 20, 2011. MMWR, 60(20), 666-68.  
3
Parker AA, Staggs W, Dayan GH, Ortega-Sanchez IR, Rota PA, Lowe L, et al. (2006). Implications of a 2005 measles
outbreak in Indiana for sustained elimination of measles in the United
States [Erratum appears in New England Journal of Medicine, (2006), 355, 1184]. New England Journal of Medicine,
355, 447-55.
4
Rooney JA, Milton JD, Hackler RL, Harris JH, Reynolds D, Tanner M, et al. (2004) The largest outbreak of measles in
the United States during 1999: imported measles and pockets of susceptibility. Journal of Infectious Diseases, 189
(Suppl. 1), S78-80. 
5
Edelson, P.J. (2012). Patterns of measles transmission among airplane travelers. Travel Medicine and Infectious
Disease, 10, 230-235. 
6
Selent MU, McWhorter A, Beau De Rochars VM, Myers R, Hunter DW, Brown CM, et al. (2011). Travel health alert
notices and Haiti cholera outbreak, Florida, USA. Emerging Infectious Diseases, 17(11):2169-71.

2CDC.

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Due to the challenges of hanging paper posters and handing out T-HANS, the Division began using
electronic monitors to deliver health messages . Electronic messages have the advantage of being
quicker and cheaper to produce, as well as providing a level of flexibility that is not feasible with
printed messaging. In addition, the electronic messages will cycle through multiple messages.
During the 2011 measles outbreak, electronic messages were displayed on CBP-owned monitors in
federal inspection services (FIS) areas (e.g., passport control, baggage claim) of airport arrival
terminals. The text-only messages, which reminded travelers to monitor themselves for signs and
symptoms of measles, and of the importance of vaccination, were displayed as part of a rotating
cycle of CBP and airport messages.
The concern that important public health messages might not be noticed by travelers if displayed
between other messages prioritized by CBP and the airport led CDC to initiate a new program that
uses CDC-owned message boards to display public health messaging. This pilot program is named
TravAlert. TravAlert is designed to optimize our use of electronic messaging in the airport
environment, by allowing CDC to control the display of public health messages at POE, maximizing
the likelihood that travelers will view them.
Health messages that are only delivered in text present a challenge since not all travelers are literate
or health literate. Pictures that are added to text-based health messages can increase attention,
comprehension, recall and adherence to the message7.
TravAlert monitors display rotating health messages that contain pictograms to reach travelers who
may have lower literacy levels or who speak languages other than English. Dedicated public health
messaging allows arriving travelers to view the message for longer periods of time as they pass
through the FIS.
TravAlert messages are comparable to printed posters with respect to providing information to
travelers. There are important differences between TravAlert and T-HANs. The paper format of the
T-HAN allows for provision of more comprehensive information to travelers, and the opportunity
for the message to be reviewed again after the traveler departs the airport. T-HANs also allow the
inclusion of messages for travelers’ healthcare providers. On the other hand, a previous evaluation
demonstrated that distribution of T-HANs by CBP officers may not reach all travelers, particularly
when targeted to specific subgroups, and many travelers do not read them6. Furthermore,
experience has shown that many T-HANs are discarded shortly after travelers receive them.
The original measles messages featured on CPB monitors in 2011 contained text only. The Division
recently updated measles messages that include pictograms with limited text. These updated
messages were designed to reach a larger audience with the important health messages, including
people who are illiterate or who are not functionally literate. Two of these messages are being
displayed on the TravAlert messaging systems and a third has been submitted for clearance.

7

Houts P., Doak C., Doak L., Loscalzo M. (2006). The role of pictures in improving health communication: A review of
research on attention, comprehension, recall, and adherence. Patient Education and Counseling, 61, 173–190

3

All three messages warn travelers that measles spreads easily and can cause serious illness. The two
updated messages that are currently in use advise travelers to 1) “get vaccinated to prevent measles”
and “protect yourself from measles” and to 2) “call a doctor if you get a fever and a rash in the next
3 weeks” and “tell the doctor that you traveled”. The third message that is under development
advises travelers to “stay home if you get fever and a rash” and to “travel only when your doctor
says it’s ok”.
TravAlert supports QBHSB’s strategic goal to expand CDC’s electronic messaging capability at
POE. Evaluation of TravAlert will provide QBHSB with important information about the
effectiveness of the placement of electronic TravAlert messaging systems and will provide DGMQ
and CDC information regarding return-on-investment for the monitors.

Measles messaging content and evaluation
This evaluation project will provide DGMQ and CDC insight into whether or not the measles
messages are understood by international travelers and whether or not the messages on the monitors
encourage uptake of the concepts displayed, such as the importance of vaccinations to prevent
disease exposure during travel. Changes in the behavior of U.S. residents and international travelers
arriving in the United States through TravAlert health messaging, including receipt of vaccination,
could help reduce morbidity and mortality among these populations and decrease the introduction,
transmission, and spread of communicable diseases with in the U.S.

Protocol Outline
Through an interagency agreement, DGMQ and the Oak Ridge Institute for Science and Education
(ORISE) will evaluate the TravAlert message content and method of delivering health messages on
electronic monitors in airports for international travelers arriving in the United States. The results
will be used to determine if DGMQ health messages displayed on monitors in the airport (see
Appendix 1) are effective in reaching the priority population and understandable to the priority
population, and if the priority population intends on following the messages on the monitors.
CIC Research, Inc., a company that conducts market surveys, has been subcontracted to collect the
data for the TravAlert Evaluation using an intercept method of sampling, recruiting, and
interviewing international travelers. CIC Research, Inc. will have two interviewers complete at least
75 one-on-one in-person interviews at each of four international airports. Exact dates and flights will
be determined by ORISE and the quarantine station staff at the respective airports. It is expected
each two person team will require at least 3 shifts of four hours each to complete at least 40
interviews.
This document provides descriptions of the following:


Goals and Objectives
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Target Population
Audience Segmentation and Screening
Methods of Data Collection
Recruitment
Interview Schedule
Human Subjects and Consent
Benefits and Risks
Analysis and Reporting
Handling of Data Records
Timeline
Rationale for Non-Research Determination Ethical Considerations
Justification for the Waiver of the Paperwork Reduction Act

Goals and Objectives
The goals of this evaluation project are to evaluate 1) the placement of the monitors in airports for
arriving international travelers to determine whether the messages are effective in reaching the target
population, 2) the understandability of the TravAlert measles messages, and 3) whether the priority
population intends on following the messages they see. This will help further inform our messaging
strategy, including providing information regarding return-on-investment for the monitors.
The objectives of this project are to evaluate whether, after having gone through the FIS at selected
U.S. airports, international travelers:
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Have seen the TravAlert measles messages on the monitors
Can recall the content of the measles messages
Are able to correctly interpret the measles messages (e.g., call a doctor if you have symptoms
of measles, get a vaccine to prevent you from getting the measles, stay home if you have a
fever and rash)
Report intention to adhere to the recommendations in the measles messages (including
getting vaccinated)
Report barriers to getting vaccinated

Target Population
The evaluation will be conducted among arriving international travelers at four U.S. airports where
TravAlert monitors are currently installed: (1) Hartsfield-Jackson Atlanta International Airport (2)
Miami International Airport (2) San Francisco International Airport (4) Washington Dulles
International Airport. In the case that the TravAlert systems are not working or they are not set up
at one of these airports, interviews may be conducted at Honolulu International Airport.
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International travelers at the above airports were selected as the target audience in order to obtain a
good representation of travelers arriving from different countries.

Participant Eligibility
Eligible participants will consist of those who are:
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International travelers arriving at one of four U.S. airports (1) Hartsfield-Jackson Atlanta
international Airport (2) Miami International Airport (2) San Francisco International Airport
(4) Washington Dulles International Airport.
Located in the FIS
Eighteen years of age or older
Able to understand and speak English

Exclusion criterion:
 Travelers with immediate connections to other international destinations

Sample Size
A minimum of 300 total interviews will be completed at the 4 airports. The number of interviews
was determined by available funding and time and estimated labor costs for data collection. It is
acknowledged that the evaluation may be underpowered; however, resources limit the investigators’
ability to get a sample size sufficiently large to power the evaluation for statistical significance.
A response rate between 49% and 88% is anticipated based on response rates from intercept
interviews conducted at a land border crossing and in the FIS of four international airports. A
response rate of 49%8 occurred with the intercept interviews with travelers at a land border crossing.
This evaluation was conducted to determine whether seasonal flu prevention posters were noticed
by travelers crossing the U.S./Mexico land border and if the posters resonated with the travelers. A
response rate as low as 77% and as high as 88% was achieved with the intercept interviews with
international travelers in four FIS. This evaluation was conducted to evaluate how “welcome”
foreign visitors felt upon processing into the U.S. by Department of Homeland Security Customs
and Border Protection officers and Border Patrol agents9.
Using a conservative estimated response rate of 49%, approximately 613 travelers will need to be
approached to obtain 300 completed interviews. It is unknown what the proportion of eligible
travelers will be since data are not available for two of the exclusion criteria: English speaking
travelers coming through the four FIS and travelers who are 18 years of age or older. Approximately

8

Oak Ridge Institute for Science and Education. (2012) Healthy Travel/Flu Prevention Posters at U.S. Ports of Entry:
Evaluation Report. Unpublished report.   
9
Ellis CS, Evans B, Santiago GM, & Reed LM. (2007). Surveying International Travelers: An Argument for Intercept
Interviewing. Presented at American Association for Public Opinion Research Conference, Anaheim, CA, May 2007.   

6

25% of Hartsfield-Jackson Atlanta International Airport, 28% of Miami International Airport, 5% of
San Francisco International Airport, and 9% of Washington Dulles International Airport’s
international travelers are connecting to another international flight and would not be eligible to
participate in the interviews.

Participant Selection, Recruitment and Eligibility Screening Process
Interviews will be conducted for a period of one to two days at each airport. To ensure diversity in
our sample, respondents will be interviewed during days and times when there are flights arriving
from several different countries.
Potential participants will be selected by CIC interviewers using a type of convenience sample (a
turn and select approach). This “turn and select” approach consists of the interviewer physically
turning then selecting and approaching the next person that they see. This approach will greatly
reduce the effects of interviewer bias in the participant selection process. Potential participants will
be approached by interviewers near the baggage claim or another convenient location after passport
processing has occurred, and will be read a recruitment script (see Appendix 2). A small token of
appreciation worth up to $10 in value will be offered to compensate travelers for their time. Tokens
will include a plastic bag containing tissues, an adult and childhood immunization schedule, QBHSB
informational cards and DGMQ magnets, lip balm, hand sanitizer, and a small first aid kit.
Recruiters will be provided with and utilize a screening tool (see Appendix 2) to ensure eligibility of
each traveler. Travelers not eligible to participate will not be interviewed and will not receive the
token of appreciation.

Consent Process
Consent will be obtained verbally prior to the interview. The interviewer will read a short script that
describes the project, its purpose, the expected time commitment for participants, and ask if the
traveler is interested in participating (see Appendix 2). If they are interested in participating, the
interviewer will ask a few screening questions (see Appendix2) to determine if the traveler is eligible
to participate. The traveler will be assured that participation is voluntary and that participation may
be terminated at any time. Participants will additionally receive a Participant Information Sheet in
English that provides an overview of the project for additional information (see Appendix 3). This
sheet includes details about sponsorship of the project, privacy and confidentiality, how the
information will be used, and who to contact for more information about the project. Participants
will have the opportunity to ask questions about the project before proceeding. Consent will be
secured by participants’ responding yes or no. The interview will proceed only if the participant
agrees to be interviewed.

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Methods of Data Collection
Data will be collected through an intercept interview administered once. Respondents will complete
the interview in a single session. Interviews will be administered in person by an interviewer(s) from
CIC. The combined time for the consent process and interview with each traveler is expected to last
5 to 7 minutes. Interviews will consist of approximately 16 questions. See Appendix 4 for interview
guide. If the traveler consents, the interview will be conducted in the baggage claim area or other
area of the FIS after passport processing. CIC interviewers will record the participants’ interview
responses using paper and pen.
CIC interviewers will also keep a tally sheet (see Appendix 5) of all travelers approached for
interview, date/time, location in the FIS where traveler was approached, whether eligible to
participate, reason for ineligibility, if applicable, and whether consent was obtained. This information
will allow calculation of the response rate as well as inform planning for future evaluations.

Handling of Data and Records
Neither CIC, who will conduct recruitment and the interviews, nor ORISE will collect any personal
identifiers including names or contact information for participants. CIC will code and validate the
data and send ORISE an electronic copy of the data in a CSV file and the original paper copies of
the surveys. Electronic records will be uploaded by CIC to a password-protected SharePoint site.
CIC Research will destroy their copies of the electronic records after ORISE has confirmed receipt.
Once uploaded, electronic records will be transferred to the firewall-protected ORISE file server.
Additionally, records will be stored in a password-protected, controlled-access folder; only the
ORISE principal investigator and co-principal investigators will have access to this folder. Paper
copies of completed interview guides will be sent to ORISE in a sealed envelope via certified mail.
ORISE will store paper copies in a locked file cabinet. CIC will also provide ORISE with a brief
report summarizing the data collection methods after they have completed the interviews at all four
airports, including number of travelers approached to participate, proportion eligible to participate
and response rate among those eligible to participate. Additionally, ORISE will
 Retain one set of the interview responses for three years, then burn, shred, or otherwise
destroy the records.
 Retain at least 1 copy of database for three years at which point all copies of the database
(paper and electronic) will be destroyed.
 Retain at least one copy of any report it produces pertaining to this project for posterity.
 Provide data in an agreed-upon format and deliver them in electronic form to CDC.
CDC will retain an electronic copy of the data in a secure location on the CDC servers.

Analysis and Reporting
Interview responses will be entered into a database by CIC Research and provided to ORISE for
analysis. Analysis will begin after receipt of the data from CIC Research and will be aimed at
answering project goals and objectives. ORISE staff will analyze data using PASW Statistics 18 and
will calculate descriptive statistics for quantitative items (e.g., percentages, means, medians,
ranges). Items that are open ended and qualitative in nature will be summarized/analyzed using
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qualitative methods, dependent upon the number of, as well as length of, responses for a given
item. NVivo 10 will be used to organize and analyze the qualitative data.
Analyses will be conducted to determine if participants 1) have seen the messages on the electronic
monitors 2) can recall the contents of the messages 3) are able to correctly interpret the message(s)
and 4) report intention to adhere to the message(s). In order to determine if participants have seen
the messages, can recall the contents of the messages, are able to correctly interpret the message, and
report intention to adhere to the messages, descriptive statistics will be used to summarize the
data. Responses of travelers who saw the TravAlert measles messages and those who did not will be
compared to identify differences in behavioral intent related to the messages (i.e., calling a doctor if
they develop symptoms of measles, receiving measles vaccine if not already vaccinated). In order to
facilitate providing descriptive statistics related to being able to correctly interpret the message,
qualitative analyses will be used to determine if a correct response was provided. ORISE will
produce a report that summarizes the interview findings, including recommendations for
improvement of the messages and methods. Additionally, ORISE will produce a PowerPoint
presentation that summarizes the project, major findings, and recommendations. The report and
PowerPoint presentation slides will be provided to CDC in August 2013.

Rationale for Non-Research Determination
The Quarantine and Border Health Services Branch (QBHSB) is requesting a non-research
determination based on the following:
 The proposed activities represent an evaluation of QBHSB’s TravAlert messaging program.
 The purpose of the proposed interviews is to improve QBHSB’s public health messaging
activities for international travelers in U.S. airports.
 The activities are intended to improve a standard public health intervention by providing
insight into whether the monitors are placed in appropriate locations to reach the target
population, and if the target population is able to are correctly interpret the messages.
 The proposed interviews are not intended to obtain generalizable knowledge or to further
the body of knowledge about health communication methods.

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Human Subjects and Ethical Considerations
This activity poses minimal risk to participants. Participation is voluntary, will not affect participants’
entry into the United States or delay travel. Interviews will occur after passport processing and will
not include any travelers with connecting flights. Participants will be informed about their role in the
project, be assured of their confidentiality, and be allowed to terminate participation at any time
during the interview. Tokens of appreciation provided to participants have nominal value and are
not likely to cause undue influence on the decision to participate.
Each interview guide will contain a participant number. The participant number will bear no
relationship to the participants’ personal identifiers, as no names, dates of birth, or other identifying
information will be asked or recorded as part of the interview or at any point in the project. Consent
will be obtained verbally and documented by participant number.
Interview questions are nonsensitive; participants will be asked whether they saw electronic monitors
displaying measles messages in the FIS, whether they understood the messages, whether they intend
to act on the messages, and whether they would face any barriers to getting a measles vaccine. Voice
recordings will not be made of the interviews. No photographs will be taken by project staff that
may be used to identify participants. Data will only be presented in aggregate.
Variations from this protocol and interview guide will not be made without prior approval by
ORISE and CDC.

Potential Risks
No personally identifiable information is being collected. There is a small risk to disclosure of
personal information; however, the information will not be recorded. The airport environment does
not offer much opportunity to maintain privacy and prevent participants’ responses from being
heard by others in the area; however, it is unlikely that any harm would result from this since no
sensitive information will be asked during the interviews. A similar evaluation (Evaluation of the
Travelers’ Health Port of Entry Influenza Posters) performed interviews with travelers in line at a
border crossing did not present challenges or concerns regarding recruitment or privacy.
Delays to travelers are a small possibility, including the possibility of missed flight connections;
however, every effort will be made to ensure that this does not happen. Interviews will take place in
the baggage claim area, where travelers typically spend time waiting for their luggage. Interviewees
will also be advised of the expected time to complete the interview as part of the consent process.
Those who state that they do not have time to complete the interview will not be interviewed.

Justification for the Waiver of the Paperwork Reduction Act
CDC’s, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of
Global Migration and Quarantine (DGMQ), Quarantine and Border Health Services Branch
(QBHS) requested a waiver of the Paperwork Reduction Act application for their project entitled
“Evaluation of the TravAlert Electronic Messaging System.”
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The Quarantine and Border Health Services Branch sought the waiver based on section 321 of the
National Childhood Vaccine Injury Act (NCVIA) (Public Law 99-660) which waives the application
of the Paperwork Reduction Act to activities conducted under the NCVIA which include
“monitoring the need and the effectiveness and adverse effects of vaccines and immunization
activities,” which can be found at 42 U.S.C. § 300aa-2(a)(7).
The project for which approval is sought is in accordance with the National Childhood Vaccine
Injury Act (Public Law 99-660) because it supports efforts to encourage public acceptance of the
measles vaccine.
Distribution and use of vaccines: The Director of the Program shall, through the plan issued under
section 300aa-3 of this title, coordinate and provide direction to the Centers for Disease Control and
Prevention and assistance to States, localities, and health practitioners in the distribution and use of
vaccines, including efforts to encourage public acceptance of immunizations and to make health
practitioners and the public aware of potential adverse reactions and contraindications to vaccines.
Evaluating the need for and the effectiveness and adverse effects of vaccines and immunization
activities: The Director of the Program shall, through the plan issued under section 300aa-3 of this
title, coordinate and provide direction to the National Institutes of Health, the Centers for Disease
Control and Prevention, the Office of Biologics Research and Review of the Food and Drug
Administration, the National Center for Health Statistics, the National Center for Health Services
Research and Health Care Technology Assessment and the Centers for Medicare and Medicaid
Services in monitoring the need for and the effectiveness and adverse effects of vaccines and
immunization activities.
This waiver will allow the Quarantine and Border Health Services Branch to collect information
about the effect that port of entry measles vaccine messaging has international travelers arriving at
the specific airports, including their knowledge, attitudes, behavioral intent, and barriers regarding
measles vaccination and the effectiveness of the messaging system.

Interview Schedule
Data will be collected over a three-month period in April through June, 2013. While interviews are
typically conducted over a variety of days (balanced to cover both weekdays and weekends, as well
as various times of the day), ORISE will reach out to the quarantine stations at the 4 participating
airports to determine the best days and times to conduct the interviews based on flight arrival times,
the need to interview travelers coming from multiple countries, and the availability of Quarantine
Station staff to escort the interviewers during their time in the FIS.
It is estimated that it will take one to two days to conduct approximately 75 interviews at each
airport.

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Timeline
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Timeline of all activities
o Participant recruitment
o Interview administration
o Data collection/entry
o Delivery of raw data file to ORISE
o Delivery of completed surveys to ORISE

o Data analysis and reporting
Delivery of report and PPT presentation to CDC

o Delivery of data in an agreed upon format to CDC

April-June 2013
April-June 2013
30 days from close of data
collection at each airport
30 days from close of data
collection at last airport
30 days from close of data
collection at last airport
August 2013
August 2013
August 2013

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Appendix 1: Messages on Screen

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The message below is currently under development and may be included if cleared in time.

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Appendix 2: Recruitment and Screening Tool

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TravAlert Evaluation: Recruitment and Screening Tool
Hi, my name is [INSERT FIRST NAME}and I am working with the Centers for Disease Control
and Prevention (CDC) to conduct a 5-minute interview about your thoughts on health messages in
this airport. We will use the information from this survey to improve how CDC provides health
information to international travelers.
If this is something you would be interested in doing, you will receive a bag of items containing a
first aid kit, hand sanitizer, tissues, and a few other items as a token of our appreciation-are you
interested?
[If YES] First, I need to ask a few questions to make sure I can include you in the survey.

SCREENING QUESTIONS
1. Are you 18 years of age or older?

Yes

No [END]

2. Can you speak and understand English?

Yes

No [END]

3. Are you connecting to another international flight today?

Yes [END]

No

If Ended: Unfortunately, I cannot include you in the survey, thanks for your time.
If eligible: I need to give you a little more information before we start:
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

It is up to you whether you want to participate
You can skip any questions you do not want to answer.
You can stop the interview at any time.
I will ask you about health messages you may have seen in the airport.
I will not ask for your name or other personal information
Anything you say today will be kept private.

4. Are you willing to proceed with the interview?

Yes

No [END]

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Appendix 3: Participant Information Sheet

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Participant Information Sheet
Evaluation of CDC’s Electronic Messaging System for Travelers

Purpose

You are invited to share your thoughts today on health and disease messages in
the airport during a brief interview. This interview is being conducted by CIC
Research Inc., and is sponsored by the Centers for Disease Control and
Prevention (CDC) with the assistance of the Oak Ridge Institute for Science and
Education. Your answers can help CDC’s efforts to provide clear and accurate
health and disease information to international travelers.

Participation
is voluntary

While we would like to hear from you, it is up to you whether you want to
participate and you can decide to stop the interview at any time. You can also skip
any questions you do not want to answer.

Time needed
to participate

The interview is expected to take five minutes.

If you agree to
participate

You will be asked a few questions about a specific health message in the airport.
You will also be asked about certain health behaviors related to the message.
Interview participants will receive a small token of appreciation for their time.

Privacy and
confidentiality

We will not collect your name or any other information that would
identify you personally. The information we collect on the interview form
will have a number on it that cannot be used to identify you. It is possible
that other people in the airport could overhear the information you tell
us, but the questions we ask will not be sensitive.
Anything you say today will be kept private. CDC, ORISE, and CIC will follow
U.S. laws in protecting the information from the interview. Your individual
responses will not be used in any reports.

How this
information
will be used

We will use the information from this interview to improve how CDC provides
health and disease information to international travelers.

Person to
contact for
more
information

If you have any questions about the interview, you may call:
Julie Crumly, Oak Ridge Institute for Science and Education (ORISE),
Oak Ridge, TN, Phone: 865-576-8889.

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Appendix 4: Interview Guide

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TravAlert Evaluation Interview Guide
ID:
Example ID: ATLBCC029 (Atlanta Airport, Interviewer Bob C Coleman, 29th person approached)
Date:
MARK THE SEX OF THE PERSON APPROACHED]

Female Male

Demographic Questions:
1. Do you live in the United States? Yes [IF YES, GO TO 3 No [IF NO, GO TO 2]
2. a. In what country do you live? ____________________________
b. Did you visit any countries before arriving in the U.S.? _____________________
c. Are you visiting any other countries after the U.S.? ____________
d. How long do you plan on staying in the U.S.? ____________________ [Go to 4]
3. What country (countries) did you visit on your trip? ____________________[Go to 4]
4. What is (if non U.S. resident)/was (if U.S. resident) the main reason for your trip?
a. Visiting family and or friends
b. Business
c. Vacation/tourism
d. School
e. Mission or volunteering
f. Other ______________________
Environment
5. In this airport, did you see any electronic monitors or screens with health or disease
information?
Yes
[IF YES, GO TO 6]
No
[IF NO, GO TO 5A]
a. If no, where in the airport could we put monitors or screens with health information
or disease information to get your attention? _____________ [SKIP TO ITEM 13]
6. How many of these monitors or screens did you see? ________
Don’t know
7. Where did you see them? __________________________________Don’t know
8. What would be the best place(s) in the airport to put monitors or screens showing health or
disease information? ____________________________________________ Don’t know
Message Testing
9. Do you remember the main topic of the message? Yes [IF YES, GO TO 9a] No [IF NO,
GO TO 10].
a. List: ________________________ [If answer = measles, go to 11] [If answer ≠
measles, go to 10].
10. I’m going to read four (other) health topics to you. Please tell me if you saw any of these
messages on the monitors or screens (select all that apply).
b. Healthy Eating [IF SELECTED and “D” IS NOT ALSO SELECTED, SKIP
TO ITEM 12]
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c. Flu
[IF SELECTED and “D” IS NOT ALSO SELECTED, SKIP
TO ITEM 12]
d. Exercise
[IF SELECTED and “D” IS NOT ALSO SELECTED, SKIP
TO ITEM 12]
e. Measles
[IF SELECTED, GO TO ITEM 11]
f. None of these
[IF SELECTED, SKIP TO ITEM 12]
11. What did the message(s) say?
________________________________________________________________________
12. Do you think there is a better way we could have provided health or disease information?
Yes [IF YES, GO TO 12a] No [IF NO, GO TO 13].
a. What other ways? ________________________ [Go to 13].
Behavior
13. If you thought you had measles after this trip, what would you do? ___________________
Don’t know
a. Would you do anything else? ___________________
14. Have you been vaccinated for measles?
Yes [Go to ITEM 18]
No [GO TO ITEM 14a and 14b]
TO 15]
a. If no, why not? ____________________________

15.
16.
17.
18.

Don’t know [GO

b. How likely are you to get a measles vaccine in the future? Would you say you are:
1
2
3
4
5
Very likely
Somewhat likely
Not sure
Somewhat unlikely
Very unlikely
If you wanted to get a measles vaccine, where could you get one?
___________________ (where else?) ___________________
What would make it difficult for you to get a measles vaccine? ___________________
What would make it easier? ___________________
One last question. What is your age?

[Interviewer Script: “Thank you for your time, your answers will be very helpful.”]

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Appendix 5: Sample Tally Sheet

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Sample TravAlert Interview Tally Sheet

Number
Approached

Date/Time

Location
Approached

Eligible?
Y/N

If ineligible,
reason

Agreed?
Y/N

1

5/12/13

By baggage
carousel 8

N

Under 18

2

5/12/13

By baggage
carousel 5

Y

Y

3

5/12/13

By baggage
carousel 3

Y

N

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