Justification for Change Request

Change Request

September 10, 2014

Information Collection Request: Process Evaluation of “Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives”

(OMB no. 0920-0952, exp. date 12/31/2015)

Summary

CDC is currently approved to collect information from 9 state and community grantees funded under the cooperative agreement “Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives.” Paper-based collection instruments that are administered annually to the grantee organization include the “State and Community Awardee Performance Measure Reporting Tool” (Attachment 6). To improve usability, data quality, and respondent satisfaction in completing the assessment, CDC proposes to delete some fields that duplicate information in other assessments and to allow awardees to enter supplemental information in place of the deleted fields.

There are no changes to the number of respondents. The estimated burden per response will be reduced from 4.0 hours to 3 hours and 15 minutes. CDC plans to begin administering the revised instruments in 2014.  OMB approval is requested, effective immediately.

Information Collection Instruments Affected by Changes

State and Community Awardee Performance Measure Reporting Tool

The revised paper version is included as Attachment 6 (rev2)

Background and Justification

CDC is approved to collect information needed for a process and intermediate outcome evaluation of awardees funded under the Teen Pregnancy Prevention (TPP) Initiative. An integral part of the process evaluation requires documenting implementation activities. In order to conduct this process evaluation, annual assessments of performance are conducted among the nine State and Community Awardees and their local partners. The collection of performance measures is critical to understanding the implementation practices associated with evidence-based programs and contraceptive access for each awardee community. Information is collected via questionnaires and a web-based data entry system.

Performance measures are collected annually via a paper questionnaire (“State and Community Awardee Performance Measure Reporting Tool,” see Attachment 6). CDC requests OMB approval to modify the questionnaire by deleting 4 tables that duplicate information collected in the “Community and Clinical Partner Clinical Partner Needs Assessment” (Attachment 4 electronic) and to include an additional question that asks respondents to confirm that the “Community and Clinical Partner Clinical Partner Needs Assessment” is current and updated.

One additional change will be made that will make it easier to reconcile entries in the Characteristics of Program Youth table. The previous version of the State and Community Awardee Performance Measure Reporting Tool allowed awardees to report Youth who did not report Gender but did not allow awardees to specify # served or # retained. In the revised version of this form, we have added the subcategories for # served and # retained to the entry for Youth who did not report Gender. This will allow awardees to report the information for these youth consistently with the fields reported by gender. Awardees were already collecting the information but were not able to report it in the current form. The addition of the fields improves data quality as awardees are able to apply the same tabulation standards to all youth. This makes it easier to reconcile all numbers in the demographics table with the total numbers of youth served for awardees.

The proposed changes to the State and Community Awardee Performance Measure Reporting Tool reduce the estimated burden per response from 4.0 hours to 3 hours and 15 minutes. The addition of the specified fields for reporting youth # served and # retained does not change the burden. The total reduction in burden for all respondents is 37 hours. See itemized changes below.

Itemized Changes in Survey Content

The changes to the performance measure reporting tool include the addition of fields as indicated below.

Change 1. Added field to Table I.c. pages 3-4 for youth who did not report gender that specifies # served and # retained. The current field allows awardees to report youth who did not report gender and does not specify # served or # retained.

Characteristics of Program Youth1	Males		Females		Youth who did not report Gender
	# served	# retained	# served	# retained	# served	# retained
Age (one response per participant)
10 years or younger
11-12 years
13-14 years
15-16 years
17-18 years
19 years or older
Grade (one response per participant)
6th grade or lower
7-8th grade
9-10th grade
11-12th grade
GED program
Technical/vocational training
College (any year)
Not currently in school
Ethnicity (one response per participant)
Hispanic or Latino
Not Hispanic or Latino
Unknown/unreported
Race (one response per participant)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
More than one race
Unknown/unreported
Primary language spoken at home (one response per participant)
English
Spanish
Chinese
Other
Special populations (one response per participant)
None
Pregnant or parenting teens
Youth in foster care
Homeless youth
Youth in the juvenile justice system
Other (describe____________________)
Total

Change 2. The following question is added to section II to address information that is now deleted in Tables 1 to 4 in section II.

Please confirm that the information submitted in the most recently reported Clinical Partner Needs Assessment is complete with prior CDC approval for any incomplete or missing information.

Measure	YES, Complete and current	NO, Will submit a revised CPNA
Health Insurance Billing Practices and Revenue
Number of staff trained on adolescent development
Clinic use of performance measures
Use of Health Care Services by Adolescents

Change 3. Section II f. and all associated tables are deleted.

Use of health care services by adolescents

The following data may be collected via billing records, EMRs, and other methods. It is recommended that you collect these data for each month.

Data reporting period____________ indicate the date range for the data in all tables below.

FEMALE Adolescent Clients (Unduplicated) and Visits by Race/Ethnicity, Age Group, and Reporting Period

FEMALES	# Adolescent Clients (Unduplicated)	# Adolescent Visits2	# Adolescent Visits in which Contraceptive, Reproductive, or Sexual Health Services are Provided3
Hispanic/Latino(a) – All Races4
12-14 years
15-17 years
18-19 years
Total
Black or African American (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
White (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
Other (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
Unknown Race and Ethnicity
12-14 years
15-17 years
18-19 years
Total
All Races and Ethnicities
12-14 years
15-17 years
18-19 years
Total

Table 2. MALE Adolescent Clients (Unduplicated) and Visits by Race/Ethnicity, Age Group, for each Reporting Period⁵

MALES	# Adolescent Clients (Unduplicated)	# Adolescent Visits6	# Adolescent Visits in which Contraceptive, Reproductive or Sexual Health Services are Provided7
Hispanic/Latino(a) – All Races8
12-14 years
15-17 years
18-19 years
Total
Black or African American (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
White (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
Other (Non-Hispanic)
12-14 years
15-17 years
18-19 years
Total
Unknown Race and Ethnicity
12-14 years
15-17 years
18-19 years
Total
All Races and Ethnicities
12-14 years
15-17 years
18-19 years
Total

Table 3. FEMALE Adolescent Clients (Unduplicated) and Number Provided (i.e., dispensed on-site or by prescription) Contraception by Age Group, for each Reporting Period⁹

FEMALES	# Adolescent Clients (Unduplicated)
All Unduplicated Clients (Total)
12-14 years
15-17 years
18-19 years
Total
Provided Hormonal Contraception10 (not including IUDs or Implants)
12-14 years
15-17 years
18-19 years
Total
Provided the Pill
12-14 years
15-17 years
18-19 years
Total
Provided Injectable Contraception (e.g., Depo Provera)
12-14 years
15-17 years
18-19 years
Total
Provided IUD
12-14 years
15-17 years
18-19 years
Total
Provided Contraceptive Implants (e.g., Implanon)
12-14 years
15-17 years
18-19 years
Total
Provided Emergency Contraception (EC)11
12-14 years
15-17 years
18-19 years
Total
% Contraceptive Coverage12
12-14 years
15-17 years
18-19 years
Total
% LARC Coverage13
12-14 years
15-17 years
18-19 years
Total

Table 4. FEMALE Adolescent Clients (Unduplicated) and Number Provided (i.e., dispensed on-site or by prescription) Contraception by Race/Ethnicity Group, for each Reporting Period¹⁴

FEMALES	# Adolescent Clients (Unduplicated)
All Unduplicated Clients (Total)
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided Hormonal Contraception15 (not including IUDs or Implants)
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided the Pill
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided Injectable Contraception (e.g., Depo Provera)
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided IUD
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided Contraceptive Implants (e.g., Implanon)
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
Provided Emergency Contraception (EC)16
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
% Contraceptive Coverage17
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total
% LARC Coverage18
Hispanic/Latina (all races)
Black or African American (non-Hispanic)
White (non-Hispanic)
Other (non-Hispanic)
Unknown/unreported
Total

1 Characteristics may be obtained from attendance records or pre-/post-tests

2 Any visit where an adolescent is seen by a healthcare team member – not only visits designated as reproductive/sexual health visits.

3 Includes any health center visit where contraceptive , reproductive, or sexual health services are provided to the adolescent patient, regardless of the primary reason for the visit.

4 Count data for all clients that indicated Hispanic/Latino(a) ethnicity, regardless of race

5 Data should be pulled for unduplicated adolescents by hormonal contraception or IUD adopted or continued, at the time of exit from their last encounter (visit) to the health center in the given reporting period. If the client reports using more than one method of birth control, report the most effective one as the primary method (e.g., if a client is given the patch and emergency contraception as a backup method, only include information on the patch).

6 Any visit during which an adolescent is seen by a healthcare team member – not only visits designated as reproductive/sexual health visits.

7 Includes any health center visit at which contraceptive, reproductive, or sexual health services are provided to the adolescent patient, regardless of the primary reason for the visit.

8 Count data for all clients that indicated Hispanic/Latino(a) ethnicity, regardless of race

9 Data should be pulled for unduplicated adolescents by hormonal contraception or IUD adopted or continued, at the time of exit from their last encounter (visit) to the health center in the given reporting period. If the client reports using more than one method of birth control, report the most effective one as the primary method (e.g., if a client is given the patch and emergency contraception as a backup method, only include information on the patch).

10 Hormonal contraception here includes the pill, patch, ring, and injectable contraception

11 Including the provision of EC as a backup method along with another contraceptive method

12 Calculated as the proportion of all unduplicated adolescent female clients provided hormonal contraception, contraceptive implants, or IUD.

13 Calculated as the proportion of all unduplicated adolescent female clients provided contraceptive implants, or IUD.

14 Data should be pulled for unduplicated adolescents by hormonal contraception or IUD adopted or continued, at the time of exit from their last encounter (visit) to the health center in the given reporting period. If the client reports using more than one method of birth control, report the most effective one as the primary method (e.g., if a client is given the patch and emergency contraception as a backup method, only include information on the patch).

15 Hormonal contraception here includes the pill, patch, ring, and injectable contraception

16 Including the provision of EC as a backup method along with another contraceptive method

17 Calculated as the proportion of all unduplicated adolescent female clients provided hormonal contraception, contraceptive implants, or IUD.

18 Calculated as the proportion of all unduplicated adolescent female clients provided contraceptive implants, or IUD.

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