SSB_OSG_Opioid_Pledge_Final

SSB_OSG_Opioid_Pledge_Final.docx

Surgeon General’s Pledge to Stem the Opioid Epidemic

OMB: 0990-0448

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Supporting Statement B For:



Surgeon General’s Pledge to End the Opioid Crisis



Request for OMB Approval of an Emergency ICR





June 3, 2016





Parag Mehta

Chief of Staff, Office of the Surgeon General

Department of Health and Human Services



200 Independence Avenue

Washington, D.C. 20037









Telephone: 202-690-7511

Email: [email protected]



  1. Respondent Universe and Sampling Methods

The Surgeon General’s Pledge to End the Opioid Crisis will collect information from a universe consisting of all medical practitioners in the United States of America. Medical Practitioners will be sent a link to a site housing a web-form on which they may optionally participate in a pledge by providing demographic information such as Name, Profession, Specialty, and Zip Code.

Disclosure of aggregate data will not be conveyed as scientific nor statistically representative of the respondent universe. This data will only be used to portray a general idea of pledge-taker information.

  1. Procedures for the Collection of Information

A webform will be present on the website, turnthetiderx.org. On this website, medical practitioners will be able to learn about methods to help end opioid abuse as well as take a pledge. Pledge information will be collected through the webform and housed in a secure database.


  1. Methods to Maximize Response Rates and Deal with No Response

There will be a campaign surrounding this website including a mailing of invitations to take the pledge to 2.3 million medical practitioners as well as national television and town hall appearances by the Surgeon General.

  1. Tests of Procedures or Methods to be Undertaken

The website will be tested with the Commissioned Corps before being launched to the public to ensure that the webform is correctly capturing the data.

  1. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

As this information will not be disclosed as scientific nor statistically representative of a sample, there were no individuals consulted on statistical aspects.

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