Assessing the Feasibility of Disseminating Effective Health Center Products through Mobile Phone Applications

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #5 Feedback Questionnaire for Patients Visiting the Mobile Web site	Form	New	Available
Form Form #4 Feedback Questionnaire for Patients Requesting Mailed Guides	Form	New	Available
Form Form #3 Patient Interview Questions	Form and Instruction	New	Available
Form Form #2 Support Staff Focus Group Discussion Guide	Form and Instruction	New	Available
Form Form #1 Clinician Focus Group Discussion Guide	Form and Instruction	New	Available
Supporting Statement Part B -- Assessing the Feasibility of Disseminating EHC Products through Mobile Phone Apps 5-25-2012.docx	Supporting Statement B	Uploaded 2012-05-25	Available
Attachment H -- Federal Register Notice.pdf	Supplementary Document	Uploaded 2012-01-30	Available
Attachment B -- User Tested Cell Phone Messages.doc	Supplementary Document	Uploaded 2012-01-30	Available
Attachment A -- Promotional Materials.pdf	Supplementary Document	Uploaded 2012-01-30	Available
Supporting Statement Part A -- Assessing the Feasibility of Disseminating EHC Products through Mobile Phone Apps 5-25-2012.docx	Supporting Statement A	Uploaded 2012-05-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201015	Feedback Questionnaire for Patients Visiting Mobile Web site	Form	New	Feedback Questionnaire for Patients Visiting the Mobile Web site
201014	Feedback Questionnaire for Patients Requesting Mailed Guides	Form	New	Feedback Questionnaire for Patients Requesting Mailed Guides
201013	Patient Interviews	Form and Instruction	New	Patient Interview Questions
201012	Focus Groups with Support Staff	Form and Instruction	New	Support Staff Focus Group Discussion Guide
201011	Focus Groups with Clinicians	Form and Instruction	New	Clinician Focus Group Discussion Guide

ICR Details

OMB Control No: 0935-0193	ICR Reference No: 201202-0935-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Assessing the Feasibility of Disseminating Effective Health Center Products through Mobile Phone Applications
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: 06/01/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/03/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2014	24 Months From Approved
Responses	766	0	0
Time Burden (Hours)	191	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The collections proposed under this clearance include activities to assess the feasibility of using specific media and awareness-raising processes to encourage consumers who are at risk for selected health problems for which AHRQ's Effective Health Care (EHC)Program materials are available to access information about such materials using mobile phone technologies. The project will specifically focus on promoting awareness of eight consumer guides developed through the EHC Program. The guides are all published in English and Spanish-language versions. All of the guides are designed to help decision makers, including clinicians and health care consumers, use research evidence to maximize the benefits of health care, minimize harm, and optimize the use of health care resources. The project will test the feasibility of using mobile telephone technology for the dissemination of EHC Program materials to underserved health consumer populations using: a) short message services (SMS), usually referred to as texting, that can be provided to people with basic cell phone service and texting support; and b) mobile Web access that provides access to the Internet via a mobile interface.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: 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:
	76 FR 70723	11/15/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 4036	01/26/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Feedback Questionnaire for Patients Requesting Mailed Guides	Form #4	Feedback Questionnaire for Patients Requesting Mailed Guides
Feedback Questionnaire for Patients Visiting Mobile Web site	Form #5	Feedback Questionnaire for Patients Visiting the Mobile Web site
Focus Groups with Clinicians	Form #1	Clinician Focus Group Discussion Guide
Focus Groups with Support Staff	Form #2	Support Staff Focus Group Discussion Guide
Patient Interviews	Form #3	Patient Interview Questions

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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	766	0	0	766	0	0
Annual Time Burden (Hours)	191	0	0	191	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: $203,531

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)? Yes

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: 02/03/2012

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