Agency Information Collection Activities: Submission for OMB Review; Comment Request, 61144-61147 [2010-24847]
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Federal Register / Vol. 75, No. 191 / Monday, October 4, 2010 / Notices
and Availability provides advice to the
Secretary and the Assistant Secretary for
Health on a range of policy issues that
includes (1) definition of public health
parameters around safety and
availability of the blood supply and
blood products, (2) broad public health,
ethical and legal issues related to
transfusion and transplantation safety,
and (3) the implications for safety and
the availability of various economic
factors affecting product cost and
supply.
In keeping with its established
mission, the ACBSA will be asked to
review and comment on previous
ACBSA recommendations including
elements of a strategic plan for
transfusion and transplantation safety.
The review is intended to align the
transfusion and transplantation safety
initiatives to the Secretary’s Strategic
Initiatives and Key Inter-Agency
Collaborations: (https://www.hhs.gov/
secretary/about/secretarialstrategic
initiatives2010.pdf).
The Committee will also be asked to
comment and make recommendations
on prioritizing previous and outstanding
recommendations in light of the
Assistant Secretary for Health’s mission
statement: ‘‘Mobilizing Leadership in
Science and Prevention for a Healthier
Nation’’ and strategic priorities: Creating
Better Systems of Prevention;
Eliminating Health Disparities and
Achieving Health Equity; and Making
Healthy People Come Alive for all
Americans.
The public will have opportunity to
present their views to the Committee on
both meeting days. A public comment
session has been scheduled for
November 5, 2010. Comments will be
limited to five minutes per speaker and
must be pertinent to the discussion. Preregistration is required for participation
in the public comment session. Any
member of the public who would like to
participate in this session is encouraged
to contact the Executive Secretary at
his/her earliest convenience to register
for time (limited to 5 minutes) and
registration must be prior to close of
business on November 3, 2010. It is
requested that those who wish to have
printed material distributed to the
Committee provide thirty (30) copies of
the document to the Executive
Secretary, ACBSA, prior to close of
business on November 3, 2010. If it is
not possible to provide 30 copies of the
material to be distributed, then
individuals are requested to provide at
a minimum one (1) copy of the
document(s) to be distributed prior to
the close of business on November 3,
2010. It also is requested that any
member of the public who wishes to
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17:23 Oct 01, 2010
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provide comments to the Committee
utilizing electronic data projection
submit the necessary material to the
Executive Secretary prior to close of
business on November 3, 2010.
Electronic comments must adhere to
disability accessibility guidelines
(Section 508 compliance).
Dated: September 28, 2010.
Richard A. Henry,
Deputy Executive Secretary, Advisory
Committee on Blood Safety and Availability.
[FR Doc. 2010–24735 Filed 10–1–10; 8:45 am]
BILLING CODE 4150–41–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Periodically, the Substance Abuse and
Mental Health Services Administration
(SAMHSA) will publish a summary of
information collection requests under
OMB review, in compliance with the
Paperwork Reduction Act (44 U.S.C.
Chapter 35). To request a copy of these
documents, call the SAMHSA Reports
Clearance Officer on (240) 276–1243.
Proposed Project: Evaluation of
Pregnant and Postpartum Women
(PPW) Program
The Substance Abuse and Mental
Health Services Administration
(SAMHSA), Center for Substance Abuse
Treatment (CSAT), is funding 11 fiscal
year (FY) 2009 Services Grants for the
Residential Treatment for Pregnant and
Postpartum Women (PPW) Program.
The purpose of the PPW Program is to
provide cost-effective, comprehensive,
residential treatment services for
pregnant and postpartum women who
suffer from alcohol and other drug use
problems, and for their infants and
children impacted by the perinatal and
environmental effects of maternal
substance use and abuse.
Section 508 [290bb–1] of the Public
Health Service Act mandates the
evaluation and dissemination of
findings of residential treatment
programs for pregnant and postpartum
women. This cross-site accountability
assessment will assess project activities
implemented for these services.
CSAT is requesting approval for a
total of 8,404 burden hours for this new
data collection. CSAT is requesting
approval for a total of 23 instruments.
Of these 23 instruments, 18 instruments
are client-level tools and 5 instruments
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are process-level tools. To examine the
effectiveness and impact of the PPW
program, the current design includes
both client-level outcomes and process
evaluation components. The purpose of
the outcome evaluation component is to
examine the extent to which grantees
accomplish the five core goals specified
by the PPW program request for
applications (RFA). These goals include:
• Decrease the use and/or abuse of
prescription drugs, alcohol, tobacco,
illicit and other harmful drugs (e.g.,
inhalants) among pregnant and
postpartum women;
• Increase safe and healthy
pregnancies; improve birth outcomes;
and reduce related effects of maternal
drug abuse on infants and children;
• Improve the mental and physical
health of the women and children;
• Improve family functioning,
economic stability, and quality of life;
and
• Decrease involvement in and
exposure to crime, violence, sexual and
physical abuse, and child abuse and
neglect.
In order to help interpret client-level
outcomes, the process evaluation will
explore what grantees are actually
doing, how well they are doing it, any
challenges encountered, and strategies
grantees used to address them.
Data collection instruments will be
used to collect outcome and process
data for this cross-site accountability
evaluation, program and treatment
planning, and local evaluations. For
clients, data will be collected from
women at four time points (intake, 6months post-intake, discharge, and 6months post-discharge), consistent with
the GPRA data collection schedule. The
schedule for collecting child data is
similar to the mothers, with the addition
of a 3-month post-intake time point. The
following interview instruments will be
used for women, fathers/mother’s
partner, and children:
Women Focused Tools
• BASIS–24® (psychological
symptomology).
• Child Abuse Potential Inventory
(overall risk for child physical abuse).
• Ferrans and Powers Quality of Life
Index (quality of life measure).
• Family Support Scale (helpfulness
of sources of support to parents raising
a young child).
• Women’s Discharge Tool (services
received, length of stay, treatment goals
achieved).
• Staff Completed Women’s Items
(pregnancy status, problems and
outcomes).
• Items Administered to Women
(children residing with mother in
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treatment, tobacco use, physical abuse
and sexual abuse in the past year).
Father and Partner Focused Tools
• Ferrans and Powers Quality of Life
Index (quality of life measure).
Child Focused Tools
• Brief Infant Toddler Social and
Emotional Assessment (children 12–35
months; social and emotional
assessment).
• Child Data Collection Tool (all
children; descriptive biopsychosocial
measure).
• Children’s Discharge Tool (all
children; services received, length of
stay, treatment goals achieved, whether
child lived in the facility).
• CRAFFT (children 11–17;
adolescent substance use screen).
• Newborn’s Medical Record Audit
(childen birth-3 months; birth
outcomes).
• Parenting Relationship
Questionnaire (children 2–17 years;
parent’s relationship with child).
• Parenting Stress Index (children 1
month—12 years; parenting stress).
• Social Skills Improvement System
(children 3–17 years; social skills).
• Trauma Symptom Checklist for
Young Children (3–12 years; trauma
symptoms).
• Staff Completed Child Items
(children 0–17; prematurity, child’s
recent primary residence, whether child
will reside in treatment with mother).
• Staff Completed Newborn Items
(children 0–3 months; prematurity,
length of stay in hospital, neonatal
intensive care unit (NICU), and
treatment for neononatal abstinence
syndrome).
Note that all child focused tools are
records reviews or administered as
maternal interviews with the exception
of CRAFFT, which is administered to
the children directly.
Process Evaluation Tools
• Biannual Project Director
Telephone Interview (interview with
grantee project directors to clarify
information reported in their biannual
progress reports);
• Site Visit Protocol—Client Focus
Group (focus groups with clients to
gather information about their
experience in the program);
• Site Visit Protocol—Clinical
Director(s)/Supervisor(s) (interviews
with both the director of clinical
services for women and the director of
clinical services for children to gather
more specific information about clinical
services);
• Site Visit Protocol—Counselor(s)
(interviews with counselors to gather
information related to daily treatment
operations and their experience in
providing services); and
• Site Visit Protocol—Program
Director (interview with grantee
program directors to gather information
about overall PPW programmatic
issues).
All data will be collected using a
combination of observation, records
review, questionnaires, and personal
interviews. CSAT will use this data for
accountability reporting, and program
monitoring to inform public policy,
research, and programming as they
relate to the provision of women’s
services. Data produced by this study
will provide direction to the type of
technical assistance that will be
required by service providers of
women’s programming. In addition, the
data will be used by individual grantees
to support progress report efforts.
The total annualized burden to
respondents for all components of the
PPW program is estimated to be 8,404
hours. Table A–1 presents a detailed
breakdown of the annual burden for all
data collection instruments for all
respondents (i.e., mother, child, project
staff, partner/father (family members),
medical staff, project director, clinical
director, counselor, program director).
The number of respondents for all childfocused tools is weighted, based on the
percentage of children within the
appropriate age bracket in the prior
PPW evaluation. With the exception of
the CRAFFT, all child-focused tools are
completed for the child by the mother
or project staff. The burden estimates,
also summarized in Table A–2, are
based on the reported experience of the
2006 cohort, proprietary instrument
developer estimates and experience,
pre-testing of the additional items
completed by staff and administered to
women, and pre-testing of process
evaluation measures. There are no direct
costs to respondents other than their
time to participate.
TABLE A–1—DETAILED ANNUAL BURDEN FOR ALL INTERVIEWS & SURVEYS
jlentini on DSKJ8SOYB1PROD with NOTICES
Interviews and surveys
Respondent
Child Focused Interviews:
CRAFFT (11–17 yrs) 2 ................
Brief Infant Toddler Social and
Emotional Assessment (12–35
mos) 3.
Child Data Collection Tool (0–17
yrs) 4.
Parenting Relationship Questionnaire (2–17 yrs) 5.
Parenting Stress Index (1
month–12 yrs) 6.
Social Skills Improvement System (3–17 yrs) 7.
Trauma Symptom Checklist for
Young Children (3–12 yrs) 8.
Women Focused Interviews:
BASIS–24® .................................
Child Abuse Potential Inventory
Family Support Scale .................
Ferrans and Powers Quality of
Life Index (Women).
Items Administered to Women ...
Partners/Fathers Interview:
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17:23 Oct 01, 2010
Number of
respondents 1
Responses
per
respondent
Total
responses
Burden per
resp.
(hrs.)
Total burden
(hrs.)
Child ....................
Mother .................
70
141
5
5
350
705
0.08
0.17
28
120
Mother .................
440
2
880
0.75
660
Mother .................
387
5
1,935
0.25
484
Mother .................
418
10
4,180
0.5
2,090
Mother .................
326
5
1,630
0.42
685
Mother .................
290
5
1,450
0.33
479
Mother
Mother
Mother
Mother
.................
.................
.................
.................
440
440
440
440
4
4
4
4
1,760
1,760
1,760
1,760
0.25
0.33
0.17
0.17
440
581
299
299
Mother .................
440
4
1,760
0.17
299
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TABLE A–1—DETAILED ANNUAL BURDEN FOR ALL INTERVIEWS & SURVEYS—Continued
Number of
respondents 1
Responses
per
respondent
Total
responses
Burden per
resp.
(hrs.)
Total burden
(hrs.)
Interviews and surveys
Respondent
Ferrans and Powers Quality of
Life Index (Partners).
Staff Completed Items/Record Reviews at 11 Facilities:
Children’s Discharge Tool (0–17
yrs) 9.
Women’s Discharge Tool ...........
Newborn’s Medical Record Audit
(0–3 mos) 10.
Staff Completed Newborn Items
Staff Completed Child Items (0–
17 yrs) 11.
Staff
Completed
Women’s
Items 12.
Process Evaluation:
Biannual Project Director Telephone Interview.
Site Visit Protocol—Client Focus
Group 13.
Site Visit Protocol—Clinical Director/Supervisor.
Site Visit Protocol—Counselor(s)
Site Visit Protocol—Program Director.
Partner/Father .....
110
2
220
0.17
37
Project Staff .........
11
80
880
0.58
510
Project Staff .........
Medical Staff ........
11
11
40
25
440
275
0.58
0.08
255
22
Medical Staff ........
Project Staff .........
11
11
25
400
275
4,400
0.25
0.08
69
352
Project Staff .........
11
160
1,760
0.17
299
Project Director ....
11
2
22
1
22
Mother .................
176
1
176
1.5
264
Clinical Director/
Supervisor.
Counselor ............
Program Director
22
1
22
2
44
33
11
1
1
33
11
1
3
33
33
..............................
4,701
........................
28,444
........................
8,404
Total .....................................
1 Data
will be collected from women at four time points (intake, 6-months post-intake, discharge, and 6-months post-discharge), consistent with
the GPRA data collection schedule. Figures in this table are based on 40 mothers per site with 2 children and 0.25 father/partner per mother.
The schedule for collecting child data is similar to the mother’s with the addition of a 3-months post-intake time point with selected tools for a
total of five time points. All child focused tools are completed by the mother or project staff, with the exception of CRAFFT. For fathers and partners, data will be collected at two points (intake and discharge).
2 Based on 8% of 880 minor children ages 11 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
3 Based on 16% of 880 minor children ages 12–35 months at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
4 Based on 440 mothers having 2 minor children at intake and/or delivery.
5 Based on 44% of 880 minor children ages 2 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
6 Based on 95% of 880 minor children ages 1 month to 12 years (n = 836). For simplicity, this calculation assumes that 95% of mothers have
two children in this age group and complete the tool for each child at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
7 Based on 37% of 880 minor children ages 3 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
8 Based on 33% of 880 minor children ages 3 to 12 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
9 Based on 1 staff member at each of the 11 programs completing the tool for 80 children at discharge.
10 Based on 31% of 880 minor children ages 0–3 months at intake or delivery.
11 Based on 80 minor children per site ages 0 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
12 Based on 1 staff member at each of the 11 programs completing items for 40 women at intake, 6 months, discharge, and 6-months post-discharge.
13 Based on 2 focus groups with 8 mothers at each site.
TABLE A–2—SUMMARY TOTAL ANNUAL RESPONDENT BURDEN
Number of
respondents
Respondent
Responses
per
respondent
Total
responses
Hours per
response
Total hour
burden
440
110
70
11
11
11
22
33
11
........................
........................
........................
........................
........................
........................
........................
........................
........................
19,756
220
350
550
7,480
22
22
33
11
........................
........................
........................
........................
........................
........................
........................
........................
........................
6,700
37
28
91
1,416
22
44
33
33
Total ..............................................................................
jlentini on DSKJ8SOYB1PROD with NOTICES
Mothers ................................................................................
Partners/Fathers ..................................................................
Children (11–17 yrs) ............................................................
Medical Staff ........................................................................
Project Staff .........................................................................
Project Director ....................................................................
Clinical Director/Supervisor ..................................................
Counselor .............................................................................
Program Director ..................................................................
719
........................
28,444
........................
8,404
Note: Total number of respondents
represents the number of each type of
respondent that will be completing at least
one tool across eleven sites over one year of
data collection. The number of respondents
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17:23 Oct 01, 2010
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(719) reported on this table differs from Table
A–1 total number of respondents (4,701)
which reflects completion of all tools across
eleven sites over one year of data collection.
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Written comments and
recommendations concerning the
proposed information collection should
be sent by November 3, 2010 to:
SAMHSA Desk Officer, Human
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04OCN1
Federal Register / Vol. 75, No. 191 / Monday, October 4, 2010 / Notices
outcome assessment will examine the
effectiveness of the State Videos project
in meeting the core project objectives
and will capture the State’s
dissemination efforts. The process and
outcome assessments will encompass
State videos that will be produced in
2010–2013 and those that were
produced in 2007 and 2009. State
contacts will be asked to update their
Dated: September 28, 2010.
dissemination information online if
Elaine Parry,
there have been changes in these figures
Director, Office of Management, Technology
during the previous 6 months, up
and Operations.
through 2013. Additionally, data will be
[FR Doc. 2010–24847 Filed 10–1–10; 8:45 am]
collected from viewers of the State
BILLING CODE 4162–20–P
videos using an online survey.
The information will be collected
from the primary contact employee
DEPARTMENT OF HEALTH AND
designated by the States that have
HUMAN SERVICES
agreed to participate in the production
of a video for the State Videos project.
Substance Abuse and Mental Health
The viewers’ information will be
Services Administration
collected from those who voluntarily
decide to complete a short survey after
Agency Information Collection
seeing the video.
Activities: Submission for OMB
SAMHSA/CSAP intends to support
Review; Comment Request
annual videos on State underage
Periodically, the Substance Abuse and drinking prevention videos. The
Mental Health Services Administration
information collected will be used by
(SAMHSA) will publish a summary of
CSAP to help plan for these annual
information collection requests under
video productions and provide
OMB review, in compliance with the
technical assistance to the participating
Paperwork Reduction Act (44 U.S.C.
States. The collected information will
Chapter 35). To request a copy of these
also provide a descriptive picture of the
documents, call the SAMHSA Reports
initiative, indicate how the videos have
Clearance Officer on (240) 276–1243.
been received, and highlight some
factors that may be associated with
Project: Assessment of the Underage
successful dissemination outcomes.
Drinking Prevention Education
The information needs to be obtained
Initiatives State Videos Project—New
using a combination of initial telephone
The Substance Abuse and Mental
interviews to collect process data,
Health Services Administration’s Center followed by online forms to collect
for Substance Abuse Prevention (CSAP) outcome and dissemination data. A
is requesting Office of Management and survey of viewers, collected online, will
Budget (OMB) approval of three new
also be used to assess the effectiveness
data collection instruments—
of the State videos in increasing
• State Video Contacts Form.
awareness of the underage drinking
• Video Viewers Form.
prevention activities in these States.
• Dissemination Update Online Form. This information collection is being
This new information collection is for implemented under authority of Section
the assessment of the 2010–2013
501(d)(4) of the Public Health Service
Underage Drinking Prevention
Act (42 U.S.C. 290aa).
Education Initiatives State Videos
State staff members will be contacted
project. In 2007, four States participated once the video has been finalized. These
in a pilot study to produce videos on the State staff members will be asked to
topic of underage drinking prevention.
complete a short telephone interview
Based upon the success of those videos, that asks questions about the process of
10 additional States and 1 Territory
producing the State video. The State
were provided funds to produce videos
Video Contacts Form includes nine
in 2009. Contingent on available funds,
items about the State video, including:
CSAP hopes to invite approximately 10
• State’s objectives for the video on
States/Territories per year to produce
underage drinking prevention.
their own videos.
• Targeted audiences.
Over the next 4 years, CSAP will
• Satisfaction with technical
conduct a process and outcome
assistance (TA) received.
assessment of this project. The process
• Usefulness of preplanning
assessment will focus on the
materials.
• Helpfulness of TA during different
experiences associated with planning
phases of production.
and producing the State videos. The
jlentini on DSKJ8SOYB1PROD with NOTICES
Resources and Housing Branch, Office
of Management and Budget, New
Executive Office Building, Room 10235,
Washington, DC 20503; due to potential
delays in OMB’s receipt and processing
of mail sent through the U.S. Postal
Service, respondents are encouraged to
submit comments by fax to: 202–395–
7285.
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17:23 Oct 01, 2010
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61147
• Recommendations for improving
the process.
• Recommendations for improving
the content of the video.
• Advice to other States interested in
producing a video.
If the State has disseminated the
video at the time of the initial telephone
interview, then they will also be asked
to complete the second part of the State
Video Contacts Form, which collects
information on dissemination outcomes.
The State Video Contacts Form includes
19 items about the dissemination
activities of the State’s video, including:
• Time when they disseminated the
video.
• Methods of dissemination.
• Number of people who viewed the
video.
• Number of DVDs and videotapes
requested.
• Effectiveness of the dissemination
methods.
• Factors that contributed to the
effectiveness of dissemination.
• Effect of TA received.
• Effect of the video in raising
awareness about underage drinking
prevention successes in the State.
• Effect of the video in raising
awareness about underage drinking
prevention challenges in the State.
• Effectiveness of the video in
presenting State’s/Territory’s prevention
activities.
• Feedback received.
• Unintended positive outcomes.
• Effect of TA in improving the
capacity to provide effective prevention
services.
After the State points of contact have
completed the State Video Contacts
Form online, they will be requested to
update dissemination activities online if
there have been any changes during the
past 6 months. This form includes seven
items, including:
• If there have been changes in
dissemination during the past 6 months.
• Most recent dissemination numbers
by method.
• Facilitation factors.
• Additional feedback.
• Additional unintended positive
outcomes.
Data will also be collected from
viewers of the State videos. Each State
video will include instructions to
viewers on how to access the Video
Viewers Form. The instructions may be
a unique URL, or they may consist of
instructions on each State’s Web site on
underage drinking prevention. This
information will allow the CSAP to
provide feedback to the States on their
video and to measure the effectiveness
of their video. The Video Viewers Form
includes 24 items about the video,
including:
E:\FR\FM\04OCN1.SGM
04OCN1
Agencies
[Federal Register Volume 75, Number 191 (Monday, October 4, 2010)]
[Notices]
[Pages 61144-61147]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-24847]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
Periodically, the Substance Abuse and Mental Health Services
Administration (SAMHSA) will publish a summary of information
collection requests under OMB review, in compliance with the Paperwork
Reduction Act (44 U.S.C. Chapter 35). To request a copy of these
documents, call the SAMHSA Reports Clearance Officer on (240) 276-1243.
Proposed Project: Evaluation of Pregnant and Postpartum Women (PPW)
Program
The Substance Abuse and Mental Health Services Administration
(SAMHSA), Center for Substance Abuse Treatment (CSAT), is funding 11
fiscal year (FY) 2009 Services Grants for the Residential Treatment for
Pregnant and Postpartum Women (PPW) Program. The purpose of the PPW
Program is to provide cost-effective, comprehensive, residential
treatment services for pregnant and postpartum women who suffer from
alcohol and other drug use problems, and for their infants and children
impacted by the perinatal and environmental effects of maternal
substance use and abuse.
Section 508 [290bb-1] of the Public Health Service Act mandates the
evaluation and dissemination of findings of residential treatment
programs for pregnant and postpartum women. This cross-site
accountability assessment will assess project activities implemented
for these services.
CSAT is requesting approval for a total of 8,404 burden hours for
this new data collection. CSAT is requesting approval for a total of 23
instruments. Of these 23 instruments, 18 instruments are client-level
tools and 5 instruments are process-level tools. To examine the
effectiveness and impact of the PPW program, the current design
includes both client-level outcomes and process evaluation components.
The purpose of the outcome evaluation component is to examine the
extent to which grantees accomplish the five core goals specified by
the PPW program request for applications (RFA). These goals include:
Decrease the use and/or abuse of prescription drugs,
alcohol, tobacco, illicit and other harmful drugs (e.g., inhalants)
among pregnant and postpartum women;
Increase safe and healthy pregnancies; improve birth
outcomes; and reduce related effects of maternal drug abuse on infants
and children;
Improve the mental and physical health of the women and
children;
Improve family functioning, economic stability, and
quality of life; and
Decrease involvement in and exposure to crime, violence,
sexual and physical abuse, and child abuse and neglect.
In order to help interpret client-level outcomes, the process
evaluation will explore what grantees are actually doing, how well they
are doing it, any challenges encountered, and strategies grantees used
to address them.
Data collection instruments will be used to collect outcome and
process data for this cross-site accountability evaluation, program and
treatment planning, and local evaluations. For clients, data will be
collected from women at four time points (intake, 6-months post-intake,
discharge, and 6-months post-discharge), consistent with the GPRA data
collection schedule. The schedule for collecting child data is similar
to the mothers, with the addition of a 3-month post-intake time point.
The following interview instruments will be used for women, fathers/
mother's partner, and children:
Women Focused Tools
BASIS-24[supreg] (psychological symptomology).
Child Abuse Potential Inventory (overall risk for child
physical abuse).
Ferrans and Powers Quality of Life Index (quality of life
measure).
Family Support Scale (helpfulness of sources of support to
parents raising a young child).
Women's Discharge Tool (services received, length of stay,
treatment goals achieved).
Staff Completed Women's Items (pregnancy status, problems
and outcomes).
Items Administered to Women (children residing with mother
in
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treatment, tobacco use, physical abuse and sexual abuse in the past
year).
Father and Partner Focused Tools
Ferrans and Powers Quality of Life Index (quality of life
measure).
Child Focused Tools
Brief Infant Toddler Social and Emotional Assessment
(children 12-35 months; social and emotional assessment).
Child Data Collection Tool (all children; descriptive
biopsychosocial measure).
Children's Discharge Tool (all children; services
received, length of stay, treatment goals achieved, whether child lived
in the facility).
CRAFFT (children 11-17; adolescent substance use screen).
Newborn's Medical Record Audit (childen birth-3 months;
birth outcomes).
Parenting Relationship Questionnaire (children 2-17 years;
parent's relationship with child).
Parenting Stress Index (children 1 month--12 years;
parenting stress).
Social Skills Improvement System (children 3-17 years;
social skills).
Trauma Symptom Checklist for Young Children (3-12 years;
trauma symptoms).
Staff Completed Child Items (children 0-17; prematurity,
child's recent primary residence, whether child will reside in
treatment with mother).
Staff Completed Newborn Items (children 0-3 months;
prematurity, length of stay in hospital, neonatal intensive care unit
(NICU), and treatment for neononatal abstinence syndrome).
Note that all child focused tools are records reviews or
administered as maternal interviews with the exception of CRAFFT, which
is administered to the children directly.
Process Evaluation Tools
Biannual Project Director Telephone Interview (interview
with grantee project directors to clarify information reported in their
biannual progress reports);
Site Visit Protocol--Client Focus Group (focus groups with
clients to gather information about their experience in the program);
Site Visit Protocol--Clinical Director(s)/Supervisor(s)
(interviews with both the director of clinical services for women and
the director of clinical services for children to gather more specific
information about clinical services);
Site Visit Protocol--Counselor(s) (interviews with
counselors to gather information related to daily treatment operations
and their experience in providing services); and
Site Visit Protocol--Program Director (interview with
grantee program directors to gather information about overall PPW
programmatic issues).
All data will be collected using a combination of observation,
records review, questionnaires, and personal interviews. CSAT will use
this data for accountability reporting, and program monitoring to
inform public policy, research, and programming as they relate to the
provision of women's services. Data produced by this study will provide
direction to the type of technical assistance that will be required by
service providers of women's programming. In addition, the data will be
used by individual grantees to support progress report efforts.
The total annualized burden to respondents for all components of
the PPW program is estimated to be 8,404 hours. Table A-1 presents a
detailed breakdown of the annual burden for all data collection
instruments for all respondents (i.e., mother, child, project staff,
partner/father (family members), medical staff, project director,
clinical director, counselor, program director). The number of
respondents for all child-focused tools is weighted, based on the
percentage of children within the appropriate age bracket in the prior
PPW evaluation. With the exception of the CRAFFT, all child-focused
tools are completed for the child by the mother or project staff. The
burden estimates, also summarized in Table A-2, are based on the
reported experience of the 2006 cohort, proprietary instrument
developer estimates and experience, pre-testing of the additional items
completed by staff and administered to women, and pre-testing of
process evaluation measures. There are no direct costs to respondents
other than their time to participate.
Table A-1--Detailed Annual Burden for All Interviews & Surveys
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of
Interviews and surveys Respondent respondents Responses per Total Burden per Total burden
\1\ respondent responses resp. (hrs.) (hrs.)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Child Focused Interviews:
CRAFFT (11-17 yrs) \2\................ Child....................... 70 5 350 0.08 28
Brief Infant Toddler Social and Mother...................... 141 5 705 0.17 120
Emotional Assessment (12-35 mos) \3\.
Child Data Collection Tool (0-17 yrs) Mother...................... 440 2 880 0.75 660
\4\.
Parenting Relationship Questionnaire Mother...................... 387 5 1,935 0.25 484
(2-17 yrs) \5\.
Parenting Stress Index (1 month-12 Mother...................... 418 10 4,180 0.5 2,090
yrs) \6\.
Social Skills Improvement System (3-17 Mother...................... 326 5 1,630 0.42 685
yrs) \7\.
Trauma Symptom Checklist for Young Mother...................... 290 5 1,450 0.33 479
Children (3-12 yrs) \8\.
Women Focused Interviews:
BASIS-24[reg]......................... Mother...................... 440 4 1,760 0.25 440
Child Abuse Potential Inventory....... Mother...................... 440 4 1,760 0.33 581
Family Support Scale.................. Mother...................... 440 4 1,760 0.17 299
Ferrans and Powers Quality of Life Mother...................... 440 4 1,760 0.17 299
Index (Women).
Items Administered to Women........... Mother...................... 440 4 1,760 0.17 299
Partners/Fathers Interview:
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Ferrans and Powers Quality of Life Partner/Father.............. 110 2 220 0.17 37
Index (Partners).
Staff Completed Items/Record Reviews at 11
Facilities:
Children's Discharge Tool (0-17 yrs) Project Staff............... 11 80 880 0.58 510
\9\.
Women's Discharge Tool................ Project Staff............... 11 40 440 0.58 255
Newborn's Medical Record Audit (0-3 Medical Staff............... 11 25 275 0.08 22
mos) \10\.
Staff Completed Newborn Items......... Medical Staff............... 11 25 275 0.25 69
Staff Completed Child Items (0-17 yrs) Project Staff............... 11 400 4,400 0.08 352
\11\.
Staff Completed Women's Items \12\.... Project Staff............... 11 160 1,760 0.17 299
Process Evaluation:
Biannual Project Director Telephone Project Director............ 11 2 22 1 22
Interview.
Site Visit Protocol--Client Focus Mother...................... 176 1 176 1.5 264
Group \13\.
Site Visit Protocol--Clinical Director/ Clinical Director/Supervisor 22 1 22 2 44
Supervisor.
Site Visit Protocol--Counselor(s)..... Counselor................... 33 1 33 1 33
Site Visit Protocol--Program Director. Program Director............ 11 1 11 3 33
-------------------------------------------------------------------------------------------------------------
Total............................. ............................ 4,701 .............. 28,444 .............. 8,404
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Data will be collected from women at four time points (intake, 6-months post-intake, discharge, and 6-months post-discharge), consistent with the
GPRA data collection schedule. Figures in this table are based on 40 mothers per site with 2 children and 0.25 father/partner per mother. The schedule
for collecting child data is similar to the mother's with the addition of a 3-months post-intake time point with selected tools for a total of five
time points. All child focused tools are completed by the mother or project staff, with the exception of CRAFFT. For fathers and partners, data will
be collected at two points (intake and discharge).
\2\ Based on 8% of 880 minor children ages 11 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\3\ Based on 16% of 880 minor children ages 12-35 months at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\4\ Based on 440 mothers having 2 minor children at intake and/or delivery.
\5\ Based on 44% of 880 minor children ages 2 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\6\ Based on 95% of 880 minor children ages 1 month to 12 years (n = 836). For simplicity, this calculation assumes that 95% of mothers have two
children in this age group and complete the tool for each child at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\7\ Based on 37% of 880 minor children ages 3 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\8\ Based on 33% of 880 minor children ages 3 to 12 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\9\ Based on 1 staff member at each of the 11 programs completing the tool for 80 children at discharge.
\10\ Based on 31% of 880 minor children ages 0-3 months at intake or delivery.
\11\ Based on 80 minor children per site ages 0 to 17 at intake, 3 months, 6 months, discharge, and 6-months post-discharge.
\12\ Based on 1 staff member at each of the 11 programs completing items for 40 women at intake, 6 months, discharge, and 6-months post-discharge.
\13\ Based on 2 focus groups with 8 mothers at each site.
Table A-2--Summary Total Annual Respondent Burden
----------------------------------------------------------------------------------------------------------------
Number of Responses per Total Hours per Total hour
Respondent respondents respondent responses response burden
----------------------------------------------------------------------------------------------------------------
Mothers......................... 440 .............. 19,756 .............. 6,700
Partners/Fathers................ 110 .............. 220 .............. 37
Children (11-17 yrs)............ 70 .............. 350 .............. 28
Medical Staff................... 11 .............. 550 .............. 91
Project Staff................... 11 .............. 7,480 .............. 1,416
Project Director................ 11 .............. 22 .............. 22
Clinical Director/Supervisor.... 22 .............. 22 .............. 44
Counselor....................... 33 .............. 33 .............. 33
Program Director................ 11 .............. 11 .............. 33
-------------------------------------------------------------------------------
Total....................... 719 .............. 28,444 .............. 8,404
----------------------------------------------------------------------------------------------------------------
Note: Total number of respondents represents the number of each
type of respondent that will be completing at least one tool across
eleven sites over one year of data collection. The number of
respondents (719) reported on this table differs from Table A-1
total number of respondents (4,701) which reflects completion of all
tools across eleven sites over one year of data collection.
Written comments and recommendations concerning the proposed
information collection should be sent by November 3, 2010 to: SAMHSA
Desk Officer, Human
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Resources and Housing Branch, Office of Management and Budget, New
Executive Office Building, Room 10235, Washington, DC 20503; due to
potential delays in OMB's receipt and processing of mail sent through
the U.S. Postal Service, respondents are encouraged to submit comments
by fax to: 202-395-7285.
Dated: September 28, 2010.
Elaine Parry,
Director, Office of Management, Technology and Operations.
[FR Doc. 2010-24847 Filed 10-1-10; 8:45 am]
BILLING CODE 4162-20-P