Ssa 12-6-2012

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The National Violent Death Reporting System (NVDRS)

OMB: 0920-0607

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SUPPORTING STATEMENT FOR

OMB INFORMATION COLLECTION REQUEST


OMB# 0920-0607



Part A


19 September 2012


The National Violent Death Reporting System


Supported by:


Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Injury Prevention and Control

Division of Violence Prevention


Project Officer: Leroy Frazier, Jr.

Center for Disease Control and Prevention

4770 Buford Highway

Atlanta, GA 30341

MS F-64

Phone: 770-488-1507

Fax: 770-488-4222

Email: [email protected]






TABLE OF CONTENTS

A. JUSTIFICATION

1. Circumstances Making the Collection of Information Necessary

2. Purpose and Use of Information Collection

3. Use of Improved Information Technology and Burden Reduction

4. Efforts to Identify Duplication and Use of Similar Information

5. Impact on Small Business or Other Small Entities

  1. Consequences of Collecting the Information Less Frequently

  2. Special Circumstances Relating to Guidelines of 5 CFR 1320.5

    1. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency

9. Explanation of Any Payment or Gift to Respondents

10. Assurance of Confidentiality Provided to Respondents

11. Justification for Sensitive Questions

12. Estimates of Annualized Burden Hours and Costs

13. Estimates of Other Total Annual Cost Burden to

Respondents or Recordkeepers

14. Annualized Cost to the Federal Government

15. Explanation for Program Changes or Adjustments

16. Plans for Tabulation and Publication and Project Time Schedule

17 Reason(s) Display of OMB Expiration Date Display is Inappropriate

18. Exceptions to Certification for Paperwork Reduction Act Submissions


B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS

1. Respondent Universe and Sampling Methods

2. Procedures for the Collection of Information

3. Methods to Maximize Response Rates and Deal with Nonresponse

4. Tests of Procedures or Methods to be Undertaken

5. Individuals Consulted on Statistical Aspects and Individuals

Collecting and/or Analyzing Data


LIST OF TABLES

A12 Estimates of Annualized Burden Hours

A14 Annualized Cost to Federal Government

A16-1 Project Time Schedule

LIST OF ATTACHMENTS

1. Sections 301 and 391 of the Public Health Service Act (42

USC 241 and 42 USC 280b, respectively)

2. Federal Register Notice – Published 60 Day Federal Register Notice

3. NDVRS Coding Manual

4. Data Flow Chart

5. NVDRS Data Elements

6 Non-Research Determination



The National Violent Death Reporting System




  1. Justification


1. Circumstances Making the Collection of Information Necessary


This is a revision request for the currently approved National Violent Death Reporting System (NVDRS ) - OMB# 0920-0607, expiration date 11/30/2012. The coding manual has been updated to reflect improved guidance to system users for how to code information that has to be entered into the system. The improved coding guidance in the manual helps to ensure data is consistently entered across users. The revision includes updated coding guidance based on questions submitted to CDC staff by data abstractors and clarifications to guidance on data elements that CDC staff have observed to present challenges to abstractors.


A 3-year extension is also requested in order to continue data collection efforts and in understanding the circumstances surrounding violent deaths in the United States.


Violence is a major public health problem. The World Health Organization has estimated that 815,000 suicides and 520,000 homicides occurred in the year 2000 worldwide. Violence against others or oneself is a major public health problem in the United States, taking 50,000 lives each year. It is a particular problem for the young: homicide was second and suicide was third among leading causes of death for Americans 1-34 years of age in 2007.


Given the importance of the problem, it is noteworthy that no national surveillance system for violence exists in the United States. In contrast, the federal government has supported extensive data collection efforts for the past three decades to record information about other leading causes of death. For example, the National Highway Traffic Safety Administration has recorded the critical details of fatal motor vehicle crashes, which result in about 40,000 deaths among U.S. residents annually. That system, called the Fatality Analysis Reporting System (FARS), has existed since 1975. The result of this investment has been a better understanding of the risk factors for motor vehicle deaths, information that has helped to target safety improvements that have led to a significant decline in motor vehicle fatalities since the 1970s. The federal government, through the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, has also funded national surveillance for cancer, which is the fourth leading cause of death in younger Americans aged 1-34 years. SEER has been operating since 1973 and has been a key component of national cancer control efforts.


Aware of the longstanding gap in information about violence, public health leaders and others have been pressing the need for a national surveillance system for violent deaths since 1989. In 1999, the Institute of Medicine recommended that CDC develop a fatal intentional injury surveillance system modeled after FARS. That same year, six private foundations pooled their funds to demonstrate that data collection about violent deaths was feasible and useful. They established the National Violent Injury Statistics System (NVISS). NVISS has been administered by the Harvard Injury Control Research Center and includes 12 participating universities, health departments, and medical centers.


In 2000, dozens of medical associations, suicide prevention groups, child protection advocates, and family violence prevention organizations joined a coalition whose purpose was to secure federal funding to extend NVISS-like surveillance nationwide. Congress approved $1.5 million in funding to start the new system, called the National Violent Death Reporting System (NVDRS), in fiscal year 2002.


CDC received initial OMB approval in November 2004 and renewals in January 2007 and November 2009.


This and similar programs are authorized under section 301 (a) [42 U.S.C. 241(a)] of the Public Health Service Act and section 391 (a) [42 U.S.C. 280(b)] of the Public Service Health Act, as amended (See attachments 1). The catalog of Federal Domestic Assistance number is 93.136.


Privacy Impact Assessment


i. Overview of the Data Collection System


This surveillance system is coordinated and funded at the federal level but is dependent on separate data collection efforts in each state managed by the state health departments or their bona fide agent. The system employs a distributed software system that allows efficient, standardized data entry in each state health department. The software is provided to each state by CDC. In accordance with the system’s design principles, the data is incident-based rather than victim-based. The software includes internal validation checks and other quality control measures. State project personnel are provided coding training to help increase data quality. A coding training video has been developed to provide states with a tool to provide onsite training for new staff. States transmit collected data via an intranet connection to the CDC contractor nightly. The data is formatted and sent to the CDC monthly. The data from the states to the contractor is automatically pushed each night.


  1. Items of Information to be Collected

To fully characterize the incidents, states collect information about each incident from four primary data sources: death certificates, medical examiner/coroner records, law enforcement records, and crime lab records. Most states find it easiest to begin data collection with death certificates because the state health department itself collects death certificates. Over 250 data elements are collected on each incident from these four principal sources. The record for an incident includes information about all the victims and suspects in each incident and their relationships. All personal identifying information is stripped from the data before it leaves the states.


iii. Identification of Website (s) and Website Content Directed at Children Under 13 Years of Age


This data collection will not involve any websites or website content directed at children under the age of 13.


2. Purpose and Use of Information Collection


The purpose of the program is to continue establishing and maintaining state violent death information collection systems that form the basis of NVDRS. A violent death is defined as a death due to suicide, homicide, an event of undetermined intent, legal intervention or unintentional firearm injury. The purpose of NVDRS is to generate public health surveillance information at the national, state, and local levels that is more detailed, useful, and timely than is currently available. This information will help develop, inform, and evaluate violence prevention strategies at both state and national levels. Without this information, violence prevention efforts are often based on anecdotal, nonscientific information. This program addresses the Healthy People 2010 focus area of Injury and Violence Prevention.


We need to continue this surveillance system to allow our knowledge regarding events that surround the occurrence of a violent death to increase. States that currently collect this data are just beginning to experience the value of such a system. Violent death data gathered by states is being used to guide the development of reports, annual prevention plans and initiatives to help community understand and plan prevention strategies. The system is helping states to collaborate with data partners that have not existed in the past.


Publications that have used NVDRS data both at the state and national level include:

MMWRs – Homicides and Suicides – NVDRS 2003; Homicides and Suicides – NVDRS 2003-2004; Surveillance Summaries – Surveillance for Violent Deaths - NVDRS April 2008, March 2009, May 2010, and August 2011; State annual reports for SC, OR, VA, NJ, WI, OK, MA, AK, UT and MD; a Supplement to the journal Injury Prevention dedicated to NVDRS – December 2006; Deaths from Violence: A Look at 17 States – December 2008; and approximately 60 peer-reviewed publication by numerous researchers in the field of violence prevention.


Privacy Impact Assessment Information


States treat their data in a confidential manner and protect it with all applicable state laws for the protection of public health surveillance information.


The proposed data collection will have little or no effect on the respondent’s privacy.


3. Use of Improved Information Technology and Burden Reduction


This surveillance system employs a distributed software system that allows efficient, standardized data entry in each state health department. Data entry is accomplished in health department offices or in the field in the offices of medical examiners and police departments. States have the option of electronically importing death certificate and medical examiner/coroner data into the system (data flow chart attached). The importation function reduces the burden for manual entry and paper copies. Law enforcement and crime laboratory data are manually entered from the paper records into the NVDRS software. The software includes internal validation checks and other quality control measures. Information on violent deaths is sent via an intranet connection from the state health departments, through an information systems contractor, and on to the CDC. State project personnel are provided coding training to help increase data quality. A coding training video has been developed to provide states with a tool to provide onsite training for new staff.



4. Efforts to Identify Duplication and Use of Similar Information


There is no similar ongoing surveillance system in existence. The National Violent Injury Statistics System was a privately-funded data collection system that was expressly designed as a pilot test for NVDRS. The system ceased to collect data from its twelve local sites in 2004.


No system to date has attempted to combine information on violent deaths from such a variety of sources on such a scale. NVDRS uses information from death certificates, medical examiner/coroner records, police department records, and crime lab information. These individual sources are death-based rather than incident-based and cannot link violent deaths involved in a single incident, such as suicides followed by the homicide of the perpetrator.



5. Impact on Small Businesses or Other Small Entities


This study does not impact small businesses or other small entities. It impacts public agencies such as health departments, police departments, crime labs, and medical examiner/coroner offices, whose records are accessed in the course of data collection. A number of the data items have been flagged as optional items to allow these agencies to reduce the amount of data they collect at their discretion.


6. Consequences of Collecting the Information Less Frequently


A complete census of violent deaths is required to obtain the detail necessary for prevention at the state level. Data collection must be continuous to monitor epidemics of violence and the impact of prevention measures. States transmit collected information to the CDC contractor nightly. The data is formatted and sent to the CDC monthly. The data from the states to the contractor is automatically pushed each night. This process allows states to see any trends much quicker than previously available.



7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5


This data collection complies fully with the guidelines in 5CFR 1320.5.




8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside

the Agency


A. A 60-day Federal Register Notice was published in the Federal Register on May 8, 2012, vol. 77, No. 89, pp. 27063-64 (Attachment 2). There were no public comments.


B. NCIPC consulted with the following entities regarding this study:


NCIPC consulted with the NVDRS Implementation Work Group, which includes national injury and violence experts regarding the content of the study. Consultation began in 2002. NCIPC maintains a partnership with the national organizations that represent the major data sources used by NVDRS. The organizations include the State and Territorial Injury Prevention Directors’ Association (STIPDA), the National Association of Medical Examiners (NAME), the National Association of Public Health Statistics and Information System (NAPHSIS), the International Association of Police Chiefs (IACP) and the National Violent Injury Statistics System (NVISS).


Marcella Sorg, PhD, D-ABFA (2012)

NAME

Tel: (207) 581-2596

[email protected]


Amber Williams (2012)

Safe States Alliance (SSA)

Tel: (770) 690-9000

[email protected]


Cathy Barber (2005)

NVISS

Tel: (617) 432-1143

[email protected]


Patricia W. Potrzebowski, PhD (2012)

NAPHSIS, Executive Director

(301) 563-6001

ppotrzebowski@naphsis.org



Nancy Turner (2012)

IACP

(800) 843-4227 x821

[email protected]




9. Explanation of Any Payment or Gift to Respondents


The CDC funds state health departments or their bona fide agents to participate in NVDRS through cooperative agreements. State health departments have formed interagency agreements with police departments, medical examiner offices, and the like to share their data. In several states, the health departments have entered into contracts with the data sources to support the clerical effort required to obtain and refile case records for NVDRS abstractors. Deceased victims of violence and the people who killed them are described in the data, but they (or their next of kin) are never contacted in the collection of data.

10. Assurance of Confidentiality Provided to Respondents


The CDC Privacy Act Officer has reviewed this OMB application and has determined that the Privacy Act is not applicable. Although sensitive information and personal identifiers will be collected by state health departments (the respondents), all personally identifying information is stripped from the files before the case-level data is sent to CDC. Only selected staff working in the state NVDRS program will have access to state information.


Some states may abstract information onto worksheets as an intermediate step prior to data entry into a computer. These worksheets contain personal identifiers. They will be stored in locked file cabinets to which only state NVDRS staff will have access. Such worksheets will never be sent from the state to the CDC or to a CDC contractor.


States treat their data in a secure manner and protect it with all applicable state laws for the protection of public health surveillance information.


To ensure privacy and anonymity, a number of procedures will be implemented:


  • Data is maintained securely throughout the data collection and data processing phases. Data is stored at the state level in secured computers that reside within state health department firewalls.

  • Before any data is sent to the CDC, all identifiers that could potentially lead to identification of an individual, such as names, address, SSN, death certificate number, date of birth, etc., are stripped at the state.

  • De-identified data is sent to the CDC encrypted with secure-socket-layer technology for additional security.

  • NVDRS follows NCHS guidelines on suppression of small sample sizes in data tabulations to prevent the inadvertent identification of an individual through the combination of various demographic characteristics, e.g., a 98 year old man from Pawtucket County in Massachusetts might be readily identifiable.



11. Justification for Sensitive Questions


No sensitive questions are asked directly to individuals involved in violent incidents or their next of kin. Information on sensitive issues, e.g., mental illness and substance abuse, are collected about the deceased victims from the records of public agencies. Such items are not captured about living suspects. Such information is critical for the identification of preventive measures.


12. A. Estimates of Annualized Burden Hours and Costs


The burden was estimated as follows:


We are using the 18 funded states to estimate the annualized burden hours and costs. The number of violent deaths per year in an average state was estimated by dividing the total number of such deaths nationwide (50,000) by 50. The number of hours per death required for the state to collect this information is estimated, from the experience of current NVDRS systems, to be approximately 2.0 hours. The number of hours per death required for the public agencies working with NVDRS states to retrieve and then refile their records was estimated at 0.5 hours per death.


The coding manual has been updated to reflect improved guidances to system users for how to code information that has to be entered into the system. The improved coding guidance in the manual helps to ensure data is consistently entered across users. Improved knowledge regarding coding should help to reduce data collect burden.


Estimated Annualized Respondent Burden Hours


Type of Respondent

Form Name

No. of Respondents

No. Responses per Respondent

Average Burden per Response

(in hours)

Total Burden Hours

State Health Departments

Completion of case abstraction

18

1000

2.0

36,000

Public Agencies

Retrieving and refile records

18

1000

30/60

9,000

Total


45,000


12. B. Estimated Annualized Respondent Burden Costs:


The state health department is considered the respondent. Their total costs equals the amount of federal funding they expend in conducting the NVDRS in their state. The funding range for the is approximately $125,000 to $265,000 per state. The amount could be slightly higher for states that experience over 2300 violent deaths a year. Each state is required to identify a budget that will most often fit within the above range. The award will be based on the amount each state justifies in their application.


State Health Departments who abstract, retrieve and refile records are considered the respondents, and their cost can be estimated as 2,000 hours x 18 states x $15/hour = $540,000. Public Agencies who retrieve and refile records estimate costs at [500 hours x 18 states x $15/hour] = $135,000. In some cases, state health departments may subcontract with the public agencies or otherwise find a way to defray these costs.


Type of Respondent

No. of Respondents

No. Responses per Respondent

Average Burden per Response

(in hours)

Total Burden Hours

Hourly Wage Rate

Total Respondent Cost

State Health Departments

18

1000

2.0

36,000

$15

$540,000

Public Agencies

18

1000

30/60

9,000

$15

$135,000

Total



$675,000



13. Estimates of Other Total Annual Cost Burden to Respondents or Record

Keepers


Respondents will incur no capital or maintenance costs.


14. Annualized Cost to the Government


These costs fall into several categories, listed below:


Contractor phases, tasks, and estimated costs



LABOR


COST


ACE contract for maintenance of the data collection software


$200,000


Contracts and cooperative agreements with national data partners

$45,000





Other Direct Costs




Subcontractors


$0


Travel and subsistence


$0


Total Estimated Contract Costs


$245,000




Government costs



Personnel


Tasks


Avg. cost/yr


Senior Scientist


Program oversight


$105,000


3 Epidemiologist


Technical assistance and data usage


$270,000


3 Public Health Advisors


Programmatic, budgetary, administrative management & oversight


$260,000


Computer Informatics Specialist


Database design


$85,000


Public Health Analyst


Data quality assurance


$72,000


Sub-total




$792,000


Total annual contractual and government staff costs are approximately $1,037,000.


This is a multi-year project, with the initial cooperative agreements spanning five years. The total cost over five years for contractual and government staff will be approximately five times the annual cost plus three percent cost of living.


15. Explanation for Program Changes or Adjustments


This surveillance system began collecting data in 2003. This is a revision request for the currently approved National Violent Death Reporting System.


The coding manual has been updated to reflect improved guidance to system users for coding information to be entered into the system. The improved coding guidance in the manual helps ensure that data is consistently entered across users. This revision includes updated coding guidance based on questions submitted to CDC staff by data abstractors and clarification to guidance on data elements, observed by CDC staff, which have presented challenges to data abstractors. The previously approved ICR was approved for information gathering from 27 states, whereas this Revision Request will collect information from 18 states.



16. Plans for Tabulation and Publication and Project Time Schedule


Data aggregated across states will be presented in tabulations of outcomes such as homicide rates and suicide rates by age group. These will be released in CDC publications such as MMWR or in other, peer-reviewed publications. A web-based query system to allow electronic querying of the information has been developed and available to the public since November 2008.


Time Schedule


Task


Time Period

Preliminary analysis files

9 months after the data year

Final analysis files

21 months after the data year

Restricted Access Data files

19 months after the data year

MMWR

At least one article per year

NVDRS data query system

Updated annually

State Annual reports

Annually


Initial reports will include crude and age-adjusted rates by state for suicide, homicide, undetermined cause of death, legal intervention, unintentional firearm injury, and terrorism. Sex, race, and age-specific rates is also presented. The percent of different types of violent deaths associated with specific circumstances, eg, a history of substance abuse, will be presented. In later years, time trends will be shown. No sophisticated statistical techniques will be required to display this surveillance data.



17. Reason(s) Display of OMB Expiration Date Is Inappropriate


There are no standard paper data collection forms to be used by states. States may print out paper copies of the abstraction forms that they can modify. That will then need to be inputted into the software database. Data will be entered into software. The OMB expiration date can be displayed on the opening screen of the software if required.



18. Exceptions to Certification for Paperwork Reduction Act Submissions


This collection of information involves no exception to the Certification for Paperwork Reduction Act Submissions.






File Typeapplication/msword
File TitleTitle: Test of Four Intimate Partner Violence (IPV) Measurement Scales
AuthorLeroy Frazier
Last Modified ByCTAC
File Modified2012-12-06
File Created2012-12-06

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