GenIC Review Form - Project Proposal

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

Pandemic Influenza Nonpharmaceutical Intervention Message and Material Testing

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

Participants will be general public adults; child care/K-12 administrators; business administrators and
mass gathering administrators. Bryant Research, LLC will recruit consensual survey participants from a
recruitment firm's database, screen them, and, if applicable, include them in online focus group testing.
Respondent characteristics:
Number of subject: 90

Number of males:

45

Age range: 18-75

Number of females: 45

Racial/ethnic composition: American Indian/Asian/Black/Hispanic/Native Hawaiian/White
Special group status: (e.g., risk group, health care providers)
Type of group(s): General Public Adults; Child care/K-12 Administrators; Business
Administrators; Mass Gathering Administrators
Geographic location(s): Participants will be recruited from across the U.S. Every effort
will be made to recruit a geographically representative sample.
3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

$100 each. See attached justification.

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 video/desktop focus group

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

Messages and materials developed by CDC's Community Interventions for Infection Control Unit will be
used to educate individuals and communities on ways to slow the spread flu during an influenza pandemic
using nonpharmaceutical interventions. ORISE will not maintain any identifiers connecting any data
collected to any particular participant except for text, audio, and video records. ORISE will retain these for
three years in a password-protected electronic folder and then destroy them.
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.)
The data must be collected by August 2012 in order for final reporting to be completed by the end of the
funding deadline of September 2012.

8. Number of burden hours requested: 180

BURDEN HOURS
No. of
Participation
Respondents Time

Category of Respondent
General Public Adults

Burden

45

2

90

Child care/K-12 Administrators/Business Administrators/Mass Gathering Administrators

45

2

90

Totals

90

2

180

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

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)
17c, 16c, 7d, 5e, 1d, 36d, 4d, 6d, 29d, 10f, 26f, 65d, 67e, 33d, 66e, 10e, 106d, 105d, 67d, 63e

*** Items below to be completed by Office of Associate Director for Communication (OADC)***
1. Number of burden hours remaining in current year's allocation:

7,025

2. OADC confirmation of time-sensitivity:
Yes:
No:

Sarah Lewis
Project Officer
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