Web Based Training for Pain Management Providers (NIDA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 Health Care Providers	Form	Modified	Available
OMB Control Number 0925-0621 N44DA-9-2213 Web Based Training for PMPs Changes.doc	Supplementary Document	Uploaded 2010-11-26	Available
Attachment 5 11_1_10.docx	Supplementary Document	Uploaded 2010-11-26	Available
Attachment 5 with track changes	Supplementary Document	Uploaded 2010-11-10	Available
Memo Nov 4 2010 2213 - Nonsubstantial Change Memo.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2010-11-10	Available
Attachment 4 4_12_10.docx	Supplementary Document	Uploaded 2010-04-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192912	Health Care Providers	Form	Modified

ICR Details

OMB Control No: 0925-0621	ICR Reference No: 201011-0925-005
Status: Historical Active	Previous ICR Reference No: 201005-0925-007
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Web Based Training for Pain Management Providers (NIDA)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/26/2010
	Date Received in OIRA: 11/17/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2012	08/31/2012	08/31/2012
Responses	240	0	240
Time Burden (Hours)	180	0	180
Cost Burden (Dollars)	0	0	0

---

Abstract: An evaluation of the program will be conducted in a home or office setting with 80 pain management providers (PMPs) such as physicians, NPs, and PAs. The proposed evaluation design is a two-group (intervention and control group), randomized trial with a crossover component. The major hypotheses for the proposed evaluation are: 1) PMPs in the intervention group will show greater gains in knowledge and improvements in attitude (from pre- to post-assessment) than participants in the control group; 2) PMPs in the intervention group will show greater gains in clinical skills as measures than those in the control group; and 3) PMPs in the intervention group will retain changes in knowledge, attitudes and skills over the follow-up period of six to nine weeks.

---

Authorizing Statute(s): US Code: 42 USC 191 Name of Law: General Purpose of NIDA
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Health Care Providers	1, 2	Screening Instrument ,   Assessment Instrument

---

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	240	240	0	0	0	0
Annual Time Burden (Hours)	180	180	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $749,643

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 11/17/2010

---