Assessing the Feasibility of Disseminating Effective Health Center Products through Educational Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #5 Follow-up survey assessment for CME participants	Form	New	Available
Form Form #4 Initial survey assessment for CME participants	Form	New	Available
Form Form #3 Interview guide for faculty members	Form	New	Available
Form Form #2 Focus group topic guide for CME project directors	Form	New	Available
Form Form #1 Interview guide for CME project directors	Form	New	Available
Supporting Statement Part B -- Assessing the Feasibility of Disseminating EHC Products Through ED Activities 5-25-2012.docx	Supporting Statement B	Uploaded 2012-05-25	Available
Attachment G -- Federal Register Notice.pdf	Supplementary Document	Uploaded 2012-02-08	Available
Attachment F -- Email invitation for follow-up survey assessment.doc	Supplementary Document	Uploaded 2012-02-08	Available
rting Statement Part A -- Assessing the Feasibility of Disseminating EHC Products Through ED Activities 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
201141	Follow up Survey Assessment of CME Participants	Form	New	Follow-up survey assessment for CME participants
201140	Initial Survey Assessment of CME Participants	Form	New	Initial survey assessment for CME participants
201139	Interviews with Faculty Members	Form	New	Interview guide for faculty members
201138	Focus Group with CME Project Directors	Form	New	Focus group topic guide for CME project directors
201137	Interviews with CME Project Directors	Form	New	Interview guide for CME project directors

ICR Details

OMB Control No: 0935-0194	ICR Reference No: 201202-0935-004
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 Educational Activities
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: 02/09/2012
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	9,050	0	0
Time Burden (Hours)	785	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Agency for Healthcare Research and Quality (AHRQ) requests that the Office of Management and Budget (OMB) approve under the Paperwork Reduction Act of 1995 this collection of information from users of products provided by the John M. Eisenberg Clinical Decisions and Communications Science Center (Eisenberg Center). Information collected consists of feedback from managers, instructors, and learners about these health care guides and other products presented as part of Continuing Medical Education activities.

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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 72414	11/23/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 5255	02/02/2012
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
Focus Group with CME Project Directors	Form #2	Focus group topic guide for CME project directors
Follow up Survey Assessment of CME Participants	Form #5	Follow-up survey assessment for CME participants
Initial Survey Assessment of CME Participants	Form #4	Initial survey assessment for CME participants
Interviews with CME Project Directors	Form #1	Interview guide for CME project directors
Interviews with Faculty Members	Form #3	Interview guide for faculty members

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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	9,050	0	0	9,050	0	0
Annual Time Burden (Hours)	785	0	0	785	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: $166,417

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: 02/09/2012

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