Agency Information Collection Activities: Submission for OMB Review; Comment Request, 35406-35407 [2012-14324]
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35406
Federal Register / Vol. 77, No. 114 / Wednesday, June 13, 2012 / Notices
Type of respondents
Form name
No. of
respondents
No. of
responses per
respondent
Avg. burden
per response
(in hrs)
Certified Nursing Assistants .................................................
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
Online
Telephone
........................
297
1,188
8
34
18
71
228
914
140
559
77
310
27
109
168
672
36
144
........................
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
........................
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
30/60
........................
Central Supply Workers .......................................................
Dental Assistants .................................................................
Environmental Service Workers ..........................................
Licensed Practical Nurses ...................................................
Lab Technicians ...................................................................
Operating Room Technicians ..............................................
Registered Nurses ...............................................................
Respiratory Therapists .........................................................
Total ..............................................................................
Kimberly S. Lane,
Deputy Director, Office of Science Integrity,
Office of the Associate Director for Science,
Office of the Director, Centers for Disease
Control and Prevention.
[FR Doc. 2012–14390 Filed 6–12–12; 8:45 am]
BILLING CODE 4163–18–P
Reports Clearance Office on (301) 443–
1984.
The following request has been
submitted to the Office of Management
and Budget for review under the
Paperwork Reduction Act of 1995:
Proposed Project: Patient Navigator
Outreach and Chronic Disease
Prevention Demonstration Program
(OMB No. 0915–0346)—[Revision]
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Periodically, the Health Resources
and Services Administration (HRSA)
publishes abstracts of information
collection requests under review by the
Office of Management and Budget
(OMB), in compliance with the
Paperwork Reduction Act of 1995 (44
U.S.C. chapter 35). To request a copy of
the clearance requests submitted to
OMB for review, email
paperwork@hrsa.gov or call the HRSA
This is a revision to a data collection
previously approved for the Patient
Navigator Outreach and Chronic Disease
Prevention Demonstration Program
(PNDP). Authorized under section 340A
of the Public Health Service Act, as
amended by section 3510 of the
Affordable Care Act, PNDP supports the
development and operation of projects
to provide patient navigator services to
improve health outcomes for
individuals with cancer and other
chronic diseases, with a specific
emphasis on health disparities
populations. Award recipients are to use
grant funds to recruit, assign, train, and
employ patient navigators who have
direct knowledge of the communities
they serve in order to facilitate the care
Number of
respondents
erowe on DSK2VPTVN1PROD with NOTICES
Form
Navigated Patient Data Intake Form ...................................
VR–12 Health Status Form ..................................................
Client Opinion Form .............................................................
Sub Total-Patient Burden .............................................
Patient Navigator Survey .....................................................
Patient Navigator Encounter/Target Services Log ..............
Patient Navigator Focus Group ...........................................
Sub Total-Patient Navigator Burden .............................
Patient Medical Record and Clinic Data ..............................
Annual Clinic-Wide Clinical Performance Measures Report
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PO 00000
Frm 00056
4,827
4,827
810
4,827
46
46
46
46
10
5
Fmt 4703
149
594
4
17
9
36
114
457
70
280
39
155
14
55
84
336
18
72
2,500
of those who are at risk for or who have
cancer or other chronic diseases,
including conducting outreach to health
disparities populations. As authorized
by the statute, an evaluation of the
outcomes of the program must be
submitted to Congress. The purpose of
these data collection instruments,
including navigated patient data intake,
VR–12 health status, patient navigator
survey, patient navigator encounter/
tracking log, patient medical record and
clinic data, clinic rates (baseline
measures), quarterly reports, and focus
group discussion guides is to provide
data to inform and support the Report
to Congress for: The quantitative
analysis of baseline and benchmark
measures; aggregate information about
the patients served and program
activities; and recommendations on
whether patient navigator programs
could be used to improve patient
outcomes in other public health areas. A
single instrument, the Client Opinion
Form, has been added to this collection,
resulting in an increase of 94.77 burden
hours.
The annual estimate of burden is as
follows:
Responses
per
respondent
Total
responses
Hours per
response
1.00
2.00
1.00
........................
1.00
629.60
1.00
........................
482.70
1.00
4,827.00
9,654.00
810.00
........................
46.00
28,961.60
46.00
........................
4,827.00
5.00
0.500
0.120
0.117
........................
0.200
0.250
1.00
........................
0.170
8.000
Sfmt 4703
Total burden
(in hrs)
E:\FR\FM\13JNN1.SGM
13JNN1
Total burden
hours
2,413.50
1,158.48
94.77
3,666.75
9.20
7,240.40
46.00
7,295.60
820.59
40.00
35407
Federal Register / Vol. 77, No. 114 / Wednesday, June 13, 2012 / Notices
Number of
respondents
Form
Responses
per
respondent
Total
responses
Hours per
response
Total burden
hours
Patient Navigator Cultural Competency Checklist ...............
Patient Navigator/Health System Administrator Focus
Group ................................................................................
Grantee Health Care Provider Focus Group .......................
Social Service Provider Group ............................................
Quarterly Report ..................................................................
Sub Total-Grantee Burden ...........................................
10
4.60
46.00
1.170
53.82
50
30
50
10
165
1.00
1.00
1.00
4.00
........................
50.00
30.00
50.00
40.00
........................
1.000
1.000
1.000
1.000
........................
50.00
30.00
50.00
40.00
1,084.41
Totals .........................................................................
5,038
........................
49,392.6
........................
12,046.76
Written comments and
recommendations concerning the
proposed information collection should
be sent within 30 days of this notice to
the desk officer for HRSA, either by
email to
OIRA_submission@omb.eop.gov or by
fax to 202–395–6974. Please direct all
correspondence to the ‘‘attention of the
desk officer for HRSA.’’
Dated: June 7, 2012.
Reva Harris,
Acting Director, Division of Policy and
Information Coordination.
[FR Doc. 2012–14324 Filed 6–12–12; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Proposed Collection; Comment
Request: Clinical Mythteries: A Video
Game About Clinical Trials
In compliance with the
requirement of Section 3506(c)(2)(A) of
SUMMARY:
the Paperwork Reduction Act of 1995,
for opportunity for public comment on
proposed data collection projects, the
National Institutes of Health (NIH) will
publish periodic summaries of proposed
projects to be submitted to the Office of
Management and Budget (OMB) for
review and approval.
Proposed Collection: Title: Clinical
Mythteries: A Video Game About
Clinical Trials. Type of Information
Collection Request: NEW. Need and Use
of Information Collection: New England
Research Institutes as a contractor for
the National Heart Lung and Blood
Institute is planning to create an
engaging, informational ‘‘serious video
game’’ for adolescents about clinical
studies which: (1) Incorporates core
learning objectives; and (2) dispels
misconceptions. Two types of
information collection are planned:
• usability testing to understand gameplay/usability. This information will be
collected by focus group and will be
digitally recorded 90 minute groups.
• A pre/post randomized trial to
measure change in knowledge. This
Estimated
number of
respondents
Type of respondents
information will be collected
electronically through on-line
questionnaire.
The game will be incorporated with a
larger initiative to provide information
about clinical research (https://
www.nhlbi.nih.gov/
childrenandclinicalstudies/index.php).
Frequency of Response: Once. Affected
Public: Individuals. Type of
Respondents: Adolescents—aged 8–14.
The annual reporting burden is as
follows: Estimated Number of
Respondents: 6,148; Estimated Number
of Responses per Respondent: 1;
Average Burden Hours Per Response:
1.321; and Estimated Total Annual
Burden Hours Requested: 370. The
annualized cost to respondents is
estimated at: $3,700. There are no
Capital Costs to report. The Operating
Costs to collect this information is
estimated at $38,642.
Note: The following table should be the
same table from section A.12 of the
supporting statement.
Estimated
number of
responses per
respondent
Average
burden hours
per response
Estimated total
annual burden
hours
requested
30
250
1
1
1.5
1.3
45
325
Total ..........................................................................................................
erowe on DSK2VPTVN1PROD with NOTICES
Adolescents—Wave one .................................................................................
Adolescents—Wave two ..................................................................................
........................
........................
........................
370
Request for Comments: Written
comments and/or suggestions from the
public and affected agencies are invited
on one or more of the following points:
(1) Whether the proposed collection of
information is necessary for the proper
performance of the function of the
agency, including whether the
information will have practical utility;
(2) The accuracy of the agency’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used; (3) Ways to enhance
the quality, utility, and clarity of the
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information to be collected; and (4)
Ways to minimize the burden of the
collection of information on those who
are to respond, including the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms of
information technology.
To
request more information on the
proposed project or to obtain a copy of
the data collection plans and
instruments, contact Victoria
Pemberton, RNC, MS, CCRC, National
FOR FURTHER INFORMATION CONTACT:
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
Heart, Lung and Blood Institute, 6701
Rockledge Drive, Rm. 8109, Bethesda,
MD 20892, or call non-toll-free number
(301) 435–0510 or Email your request,
including your address to:
pembertonv@mail.nih.gov.
Comments Due Date: Comments
regarding this information collection are
best assured of having their full effect if
received within 60-days of the date of
this publication.
E:\FR\FM\13JNN1.SGM
13JNN1
]]>Agencies
[Federal Register Volume 77, Number 114 (Wednesday, June 13, 2012)]
[Notices]
[Pages 35406-35407]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-14324]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
Periodically, the Health Resources and Services Administration
(HRSA) publishes abstracts of information collection requests under
review by the Office of Management and Budget (OMB), in compliance with
the Paperwork Reduction Act of 1995 (44 U.S.C. chapter 35). To request
a copy of the clearance requests submitted to OMB for review, email
paperwork@hrsa.gov or call the HRSA Reports Clearance Office on (301)
443-1984.
The following request has been submitted to the Office of
Management and Budget for review under the Paperwork Reduction Act of
1995:
Proposed Project: Patient Navigator Outreach and Chronic Disease
Prevention Demonstration Program (OMB No. 0915-0346)--[Revision]
This is a revision to a data collection previously approved for the
Patient Navigator Outreach and Chronic Disease Prevention Demonstration
Program (PNDP). Authorized under section 340A of the Public Health
Service Act, as amended by section 3510 of the Affordable Care Act,
PNDP supports the development and operation of projects to provide
patient navigator services to improve health outcomes for individuals
with cancer and other chronic diseases, with a specific emphasis on
health disparities populations. Award recipients are to use grant funds
to recruit, assign, train, and employ patient navigators who have
direct knowledge of the communities they serve in order to facilitate
the care of those who are at risk for or who have cancer or other
chronic diseases, including conducting outreach to health disparities
populations. As authorized by the statute, an evaluation of the
outcomes of the program must be submitted to Congress. The purpose of
these data collection instruments, including navigated patient data
intake, VR-12 health status, patient navigator survey, patient
navigator encounter/tracking log, patient medical record and clinic
data, clinic rates (baseline measures), quarterly reports, and focus
group discussion guides is to provide data to inform and support the
Report to Congress for: The quantitative analysis of baseline and
benchmark measures; aggregate information about the patients served and
program activities; and recommendations on whether patient navigator
programs could be used to improve patient outcomes in other public
health areas. A single instrument, the Client Opinion Form, has been
added to this collection, resulting in an increase of 94.77 burden
hours.
The annual estimate of burden is as follows:
----------------------------------------------------------------------------------------------------------------
Number of Responses per Total Hours per Total burden
Form respondents respondent responses response hours
----------------------------------------------------------------------------------------------------------------
Navigated Patient Data Intake 4,827 1.00 4,827.00 0.500 2,413.50
Form...........................
VR-12 Health Status Form........ 4,827 2.00 9,654.00 0.120 1,158.48
Client Opinion Form............. 810 1.00 810.00 0.117 94.77
Sub Total-Patient Burden.... 4,827 .............. .............. .............. 3,666.75
Patient Navigator Survey........ 46 1.00 46.00 0.200 9.20
Patient Navigator Encounter/ 46 629.60 28,961.60 0.250 7,240.40
Target Services Log............
Patient Navigator Focus Group... 46 1.00 46.00 1.00 46.00
Sub Total-Patient Navigator 46 .............. .............. .............. 7,295.60
Burden.....................
Patient Medical Record and 10 482.70 4,827.00 0.170 820.59
Clinic Data....................
Annual Clinic-Wide Clinical 5 1.00 5.00 8.000 40.00
Performance Measures Report....
[[Page 35407]]
Patient Navigator Cultural 10 4.60 46.00 1.170 53.82
Competency Checklist...........
Patient Navigator/Health System 50 1.00 50.00 1.000 50.00
Administrator Focus Group......
Grantee Health Care Provider 30 1.00 30.00 1.000 30.00
Focus Group....................
Social Service Provider Group... 50 1.00 50.00 1.000 50.00
Quarterly Report................ 10 4.00 40.00 1.000 40.00
Sub Total-Grantee Burden.... 165 .............. .............. .............. 1,084.41
----------------------------------------------------------------------------------------------------------------
Totals.................... 5,038 .............. 49,392.6 .............. 12,046.76
----------------------------------------------------------------------------------------------------------------
Written comments and recommendations concerning the proposed
information collection should be sent within 30 days of this notice to
the desk officer for HRSA, either by email to OIRA_submission@omb.eop.gov or by fax to 202-395-6974. Please direct all
correspondence to the ``attention of the desk officer for HRSA.''
Dated: June 7, 2012.
Reva Harris,
Acting Director, Division of Policy and Information Coordination.
[FR Doc. 2012-14324 Filed 6-12-12; 8:45 am]
BILLING CODE 4165-15-P
