Agency Information Collection Activities: Proposed Collection; Comment Request
| Published date | 05 August 2020 |
| Citation | 85 FR 47374 |
| Record Number | 2020-17013 |
| Section | Notices |
| Court | Agency For Healthcare Research And Quality,Health And Human Services Department |
Federal Register, Volume 85 Issue 151 (Wednesday, August 5, 2020)
[Federal Register Volume 85, Number 151 (Wednesday, August 5, 2020)]
[Notices]
[Pages 47374-47376]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-17013]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project ``Programmatic Information Collection for the AHRQ Initiative
to Support Primary Care to Advance Cardiovascular Health in States with
High Prevalence of Preventable CVD Events.''
DATES: Comments on this notice must be received by 60 days after date
of publication of this notice.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
[email protected].
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by email at
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Programmatic Information Collection for the AHRQ Initiative To Support
Primary Care To Advance Cardiovascular Health in States With High
Prevalence of Preventable CVD Events
Despite improvements in recent years, cardiovascular disease (CVD)
is a significant national health burden and the leading cause of death,
involved in nearly one of every three deaths. Modifiable risk factors
for CVD, such as high blood pressure, high cholesterol, and smoking,
remain poorly controlled. Evidence from patient-centered outcomes
research (PCOR) shows that increasing the delivery of the ABCS of heart
health--Aspirin in high-risk individuals, Blood pressure control,
Cholesterol management, and Smoking cessation--can reduce risk and
reduce heart attacks and strokes.
In 2010, Congress established the Patient-Centered Outcomes
Research (PCOR) Trust Fund and instructed AHRQ to support the
dissemination of PCOR findings. In accordance with its mandated role,
AHRQ issued a Request for Applications (RFA) entitled Supporting
Primary Care to Advance Cardiovascular Health in States with High
Prevalence of Preventable CVD Events. AHRQ anticipates investing up to
$18 million to support a maximum of four awards. Each grantee will
establish a state-level entity--known as a Cooperative--to support
primary care improvement and run a Heart Health Quality Improvement
(QI) project. The expected earliest start date for the grants is
December 30, 2020.
This initiative has the following goals:
1. To improve heart health and help reduce CVD disparities by
engaging with primary care practices, and disseminating and
implementing PCOR findings to improve care delivery.
2. To learn how to develop sustainable state-level primary care QI
infrastructure to improve the uptake of PCOR evidence in primary care.
3. To disseminate lessons learned, which take into consideration
the context in which each program operated, on how to replicate
successes and avoid challenges.
This new grant initiative is being conducted pursuant to AHRQ's
statutory authority to support the agency's dissemination of PCOR
findings. 42 U.S.C. 299b-37(a)-(c). The information collection
described in this request is being collected under AHRQ's authority in
42 U.S.C. 299b-37(c), which authorizes AHRQ to gather feedback about
the value of the PCOR information it disseminates. The information
described in this request will be collected by AHRQ's contractor, Abt
Associates.
Method of Collection
To achieve the goals of this project the following data collections
will be implemented:
1. Key informant interviews. AHRQ will conduct phone interviews
with a variety of state-level organizations involved in primary care
support and with primary care practices. This information will be used
to develop case studies for each Cooperative as well as program-level
generalizations and lessons learned that might inform other efforts to
improve care delivery.
2. Member check-in sessions. AHRQ will conduct group phone
discussions with a subset of participants in the key informant
interviews to corroborate case studies and lessons learned, and to
provide additional shared insights across participants.
Key Informant Interviews
Individual key informant interviews will be conducted with the
following groups:
Grantee and Cooperative leadership, and Cooperative
partners--about decision to participate in the project, prior
collaborations, organization and governance of the Cooperative, nature
and extent of partnerships, what worked well and barriers, changes to
the Cooperative and their impact on provision of quality improvement
(QI) support, QI support strategies and their perceived effectiveness,
successful strategies for recruiting practices and types of practices
recruited, success in establishing state-level capacity to provide QI
support, factors associated with successful implementation of QI,
longer-term impact of the grant and sustainability of capacity
developed, suggestions for improvement, and lessons learned from the
project.
Unaffiliated organizations involved in or knowledgeable
about primary care in the states--nature and extent of connection to
the Cooperatives, awareness of the project, views about the
organization and effectiveness of the Cooperatives and their networks,
other local activities that may have affected the work of the
Cooperatives, views on changes in practice capacity to deliver better
care and on sustainability of improvements, benefits to and any
potential adverse consequences for patients, suggestions for
improvement and lessons learned from the project.
Practices within the network not participating in the
Heart Health QI project--prior collaboration and experience of
recruitment to the network, decision to participate, nature of
engagement with the Cooperative and network, benefits and drawbacks of
network participation, interest in participating in Heart Health QI
project, strategies employed to improve heart health, knowledge of and
views on QI strategies at participating practices, concurrent efforts
to improve care delivery, plans to continue participating in the
network, suggestions for improvement and lessons learned.
[[Page 47375]]
Practices within the network participating in the Heart
Health QI project--prior collaboration and experience of recruitment to
the network and Heart Health QI project, decision to participate,
nature of engagement with the Cooperative and network, benefits and
drawbacks of network participation, weaknesses in care delivery that QI
strategies are designed to address and how the practices handle these,
expectations for improvements stemming from QI projects and any
potential challenges, nature of and satisfaction with support for Heart
Health QI project, contribution of QI support to practice capacity to
improve heart health outcomes, concurrent efforts to improve care
delivery, plans to continue implementing the intervention, other
benefits of participation in the Heart Health QI project, plans to
remain in the project, suggestions for improvement and lessons learned.
A total of 200 interviews is anticipated over the course of three
years.
All interviews will be conducted by telephone and are expected to
take 45-60 minutes. Grantee and Cooperative leadership and Cooperative
partner groups will be interviewed annually for three years, while the
grants are active. Unaffiliated organizations and network practices,
including those participating in the Heart Health QI project, will be
interviewed in years 2 and 3 of the grants. This schedule of interviews
reflects the anticipated evolution of the state-level entity,
development of new partnerships, recruitment of practices to the
network, and implementation of Heart Health QI project.
All interviews will include at least one lead interviewer and a
note-taker and will be recorded with respondents' permission as a back-
up. Detailed notes will be prepared after each interview. The purpose
of the proposed information collection effort is to explore each
grantee's primary care quality improvement, including their members and
partners; and their experiences and achievements. Additionally, this
information collection will serve to help synthesize insights from
across grantees, identify key themes, and distill lessons learned,
taking into consideration the context in which each program operated.
The following knowledge will be generated to understand the
contribution of the program to developing sustainable state-level
capacity to implement PCOR findings in primary care and the pros and
cons of various Cooperative models, as well as lessons learned about
approaches to assisting practices in implementing evidence to improve
care.
Estimated Annual Respondent Burden
Table 1 presents estimates of the reporting burden hours for the
information collection efforts. Time estimates are based on prior
experiences and what can reasonably be requested of participating
entities.
Key-informant interviews. In-depth interviews will be conducted
with the total of up to 88 individuals. Respondents from Grantee and
Cooperative leadership and Cooperative partner groups will be
interviewed every year for three years. Respondents from unaffiliated
organizations and non-participating practices will be interviewed
twice, in years 2 and 3, and respondents from participating practices
once or twice in years 2 and 3. The interviews are expected to last for
up to one hour.
Member-checking sessions. Three member-checking sessions will be
conducted with a total of up to 36 participants. Grantee and
Cooperative leadership and key Cooperative organizations and partners
will participate in two sessions, in year 1 and year 3. Network
practices (those participating and not participating in heart health QI
project) will participate in a member-checking session only in year 3.
The sessions are expected to last for up to 1.5 hours.
Table 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Data collection method or project activity Number of responses per Hours per Total burden
respondents respondent response hours A*B*C
A B C D
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews:
Grantee leadership.......................... 12 3 1 36
Cooperative leadership...................... 12 3 1 36
Cooperative partners........................ 24 * 2.5 1 60
Unaffiliated organizations.................. 12 2 1 24
Practices in network not participating in 8 2 1 16
Heart Health QI project....................
Practices in network participating in Heart 20 ** 1.4 1 28
Health QI project..........................
Member Checking Sessions:
Grantee leadership.............................. 4 2 1.5 12
Cooperative leadership.......................... 4 2 1.5 12
Cooperative partners............................ 2 2 1.5 6
Unaffiliated organizations...................... 2 2 1.5 6
Network practices............................... 12 1 1.5 18
---------------------------------------------------------------
Total................................... 112 .............. .............. 254
----------------------------------------------------------------------------------------------------------------
* Note: This number reflects that in Year 1 we will only interview 12 respondents, but 24 in years 2 and 3,
hence 2.5 # of responses.
** This number reflects that in Year 2 we will interview 8 respondents and in year 3 we will interview 20
respondents.
Table 2 presents the estimated annualized cost burden associated
with the respondents' time to participate in this research. The total
cost burden is estimated to be $29,260.96.
[[Page 47376]]
Table 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Data collection method or project activity respondents hours rate burden B*C
A. B. C. D.
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews:
Grantee leadership...................... 12 36 $110.74 $3,986.64
Cooperative leadership.................. 12 36 110.74 3,986.64
Cooperative partners.................... 24 60 110.74 6,644.40
Unaffiliated organizations.............. 12 24 110.74 2,657.76
Practices in network not participating 8 16 136.49 2,183.84
in Heart Health QI project.............
Practices in network participating in 20 28 136.49 3,821.72
Heart Health QI project................
Member Checking Sessions:
Grantee leadership...................... 4 12 110.74 1,328.88
Cooperative leadership.................. 4 12 110.74 1,328.88
Cooperative partners.................... 4 6 110.74 664.44
Unaffiliated organizations.............. 2 6 110.74 664.44
Network practices....................... 12 18 110.74 1,993.32
-------------------------------------------------------------------
Total............................... 112 254 ................ 29,260.96
----------------------------------------------------------------------------------------------------------------
Note: the rates were based on the mean hourly wages from the Bureau of Labor & Statistics for the closest
categories of respondents and doubled to account for overhead and fringe.
The mean hourly wage rates were obtained from the Bureau of Labor &
Statistics and doubled to account for overhead and fringe benefits. The
occupational codes used were as follows:
For grantee and cooperative leadership, partners, and
unaffiliated organizations--medical and health service managers (11-
9111, $53.37)
For practices--an average of physicians (29-1228, $97.81),
medical and health services managers (11-9111, $53.37), and nurse
practitioners (29-1171, $53.77)
Request for Comments
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3520, comments on AHRQ's information collection are requested with
regard to any of the following: (a) Whether the proposed collection of
information is necessary for the proper performance of AHRQ's health
care research and health care information dissemination functions,
including whether the information will have practical utility; (b) the
accuracy of AHRQ's estimate of burden (including hours and costs) of
the proposed collection(s) of information; (c) ways to enhance the
quality, utility and clarity of the information to be collected; and
(d) ways to minimize the burden of the collection of information upon
the respondents, including the use of automated collection techniques
or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: July 30, 2020.
Virginia L. Mackay-Smith,
Associate Director.
[FR Doc. 2020-17013 Filed 8-4-20; 8:45 am]
BILLING CODE 4160-90-P
