Evaluation of the Educating the Educator (EtE) Workshop

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 6 Attachment F: Quarterly New Tool Usage Survey	Form and Instruction	New	Available
Form 5 Attachment E: Secondary Trainee One-time 12-month Survey	Form and Instruction	New	Available
Form 4 Attachment D: Workshop 12-month Post-Training Survey	Form and Instruction	New	Available
Form 3 Attachment C: Workshop 6-month Post-Training Survey	Form and Instruction	New	Available
Form 2 Attachment B: Workshop Post-Training Survey	Form and Instruction	New	Available
Form 1 Attachment A: Workshop Pre-Training Survey	Form and Instruction	New	Available
Supporting Statement Part A -- Evaluation of the EtE FINAL (2).doc	Supporting Statement A	Uploaded 2014-06-25	Available
ATTACHMENT H_Technical Experts Consulted for the EtE Project.docx	Supplementary Document	Uploaded 2014-06-25	Available
Supporting Statement Part B -- Evaluation of the EtE v2 11 29 2013 EB review.doc	Supporting Statement B	Uploaded 2014-06-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212072	Attachment F: Quarterly New Tool Usage Survey	Form and Instruction	New	Attachment F: Quarterly New Tool Usage Survey
212070	Attachment E: Secondary Trainee One-time 12-month Survey	Form and Instruction	New	Attachment E: Secondary Trainee One-time 12-month Survey
212069	Attachment D: Workshop 12-month Post-Training Survey	Form and Instruction	New	Attachment D: Workshop 12-month Post-Training Survey
212068	Attachment C: Workshop 6-month Post-Training Survey	Form and Instruction	New	Attachment C: Workshop 6-month Post-Training Survey
212058	Attachment B: Workshop Post-Training Survey	Form and Instruction	New	Attachment B: Workshop Post-Training Survey
212057	Attachment A: Workshop Pre-Training Survey	Form and Instruction	New	Attachment A: Workshop Pre-Training Survey

ICR Details

OMB Control No: 0935-0220	ICR Reference No: 201406-0935-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Evaluation of the Educating the Educator (EtE) Workshop
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 without change	Conclusion Date: 08/05/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/29/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	36 Months From Approved
Responses	10,200	0	0
Time Burden (Hours)	1,850	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: AHRQ's Educating the Educator (EtE) workshop training project is an Agency knowledge translation and dissemination project that aims to increase knowledge about and use of AHRQ's Effective Health Care EHC Program products among health care professionals. For the EtE project, AHRQ is sponsoring the development of an accredited, in-person, train-the-trainer workshop program for health care professionals to educate them on how to use AHRQ's EHC Program materials and resources in shared decision making (SDM) with patients/caregivers. As a train-the-trainer program, the workshop also provides education on effectively training other health care professionals to facilitate the dissemination of the key competencies taught by the program. Additionally, as part of the EtE project, a collection of new, stand-alone tools are being developed to facilitate the implementation and use of AHRQ EHC Program materials.

---

Authorizing Statute(s): US Code: 42 USC USC Sec299 Name of Law: Healthcare Research and Quality Act of 1999
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 60	03/28/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 116	06/17/2014
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Attachment A: Workshop Pre-Training Survey	1	Attachment A: Workshop Pre-Training Survey
Attachment B: Workshop Post-Training Survey	2	Attachment B: Workshop Post-Training Survey
Attachment C: Workshop 6-month Post-Training Survey	3	Attachment C: Workshop 6-month Post-Training Survey
Attachment D: Workshop 12-month Post-Training Survey	4	Attachment D: Workshop 12-month Post-Training Survey
Attachment E: Secondary Trainee One-time 12-month Survey	5	Attachment E: Secondary Trainee One-time 12-month Survey
Attachment F: Quarterly New Tool Usage Survey	6	Attachment F: Quarterly New Tool Usage Survey

---

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	10,200	0	0	10,200	0	0
Annual Time Burden (Hours)	1,850	0	0	1,850	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 ICR.

---

Annual Cost to Federal Government: $195,036

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]? Yes

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: 06/29/2014

---