Evaluation of AHRQ's Effective Health Care Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #7 Appreciative Inquiry Workshop	Form and Instruction	New	Available
Form Form #6 In-Depth Key Informant Interviews with EHC Program Users and Stakeholders	Form and Instruction	New	Available
Form Form #5 Online Survey with EHC Program Users and Stakeholders	Form and Instruction	New	Available
Form Form #4 Key Informant Interviews with EHC Program Users and Stakeholders	Form and Instruction	New	Available
Form Form #3 Key Informant Interviews with EHC Stakeholder Group Members	Form and Instruction	New	Available
Form Form #2 Online Survey with EHC Research Centers Staff	Form and Instruction	New	Available
Form Form #1 Key Informant Interviews with EHC Research Centers Staff	Form and Instruction	New	Available
EHC Responses to OMB comments 2 18 2010_Final.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment E-Online Survey.doc	Supplementary Document	Uploaded 2010-02-22	Available
AHRQ EHC Prog Gov SupportingStatementPartB_EHCgovernance 20100219 (2).docx	Supporting Statement B	Uploaded 2010-02-22	Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document	Uploaded 2009-07-15	Available
Attachment B -- 30 Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2009-07-15	Available
Attachment Q-IRB Waiver Determination Letter.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment P-Thank You at End of Survey.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment O-Follow up-Reminder Email for Survey.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment N-Email Invitation for Survey.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment M-Cover Email for Survey.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment L-Script for Follow Up Scheduling Phone Call for Interview.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment K-Thank You Email for Interview.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment J-Reminder Scheduling Email for Interview.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment I-Scheduling Email for Interview.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment H-Cover Email for Interview.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment G-Advance Letter about the Evaluation.doc	Supplementary Document	Uploaded 2010-02-22	Available
Attachment D-Interview Process Manual.doc	Supplementary Document	Uploaded 2010-02-22	Available
AHRQ EHC Prog Gov SupportingStatementPartA_EHCgovernance 20100219 (2).docx	Supporting Statement A	Uploaded 2010-02-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
190163	Appreciative Inquiry Workshop	Form and Instruction	New
190162	In-Depth Key Informant Interviews with EHC Program Users and Stakeholders	Form and Instruction	New
190161	Online Survey with EHC Program Users and Stakeholders	Form and Instruction	New
190160	Key Informant Interviews with EHC Program Users and Stakeholders	Form and Instruction	New
190159	Key Informant Interviews with EHC Stakeholder Group Members	Form and Instruction	New
190158	Online Survey with EHC Research Centers Staff	Form and Instruction	New
190157	Key Informant Interviews with EHC Research Centers Staff	Form and Instruction	New

ICR Details

OMB Control No: 0935-0160	ICR Reference No: 200907-0935-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Evaluation of AHRQ's Effective Health Care Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/26/2010
	Date Received in OIRA: 07/31/2009
Terms of Clearance: This ICR is approved consistent with revised supporting statement and instruments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2013	30 Months From Approved
Responses	407	0	0
Time Burden (Hours)	293	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this project is to evaluate the governance structure of the EHC program at AHRQ. To achieve that purpose, information will be collected to identify strengths and weaknesses in the current EHC program's governance structure, methods for engaging stakeholders, and approaches to setting priorities for the research conducted by the EHC program. The second phase of the evaluation will be to contrast the EHC program with international programs of similar purpose.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: The Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 18720	04/24/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 34019	07/14/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Key Informant Interviews with EHC Research Centers Staff	Form #1	Key Informant Interview Guide EHC Research Centers Staff
Online Survey with EHC Research Centers Staff	Form #2	Online Survey
Key Informant Interviews with EHC Program Users and Stakeholders	Form #4	Key Informant Interview Guide EHC Program Users and Stakeholders
Key Informant Interviews with EHC Stakeholder Group Members	Form #3	Key Informant Interview Guide EHC Stakeholder Group Members
Appreciative Inquiry Workshop	Form #7	Appreciative Inquiry Workshop Agenda
Online Survey with EHC Program Users and Stakeholders	Form #5	Online Survey
In-Depth Key Informant Interviews with EHC Program Users and Stakeholders	Form #6	In-Depth Key Informant Interview Protocol and Guide EHC Program Users and Stakeholders

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	407	0	0	407	0	0
Annual Time Burden (Hours)	293	0	0	293	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $268,205

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/31/2009

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