A National Survey of Nurse Coaches (CC)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Online Nurse Coach Survey	Form	New	Repair queued
30-day published FRN for Ross Nurse Coach Survey 2016-27839.pdf	Supplementary Document	Uploaded 2016-11-18	Repair queued
Attachment D ICPC email.pdf	Supplementary Document	Uploaded 2016-11-17	Repair queued
Attachment C PIA SurveyMonkey for Ross Nurse Coach Survey CC 2016.docx	Supplementary Document	Uploaded 2016-11-17	Repair queued
Attachment B OHSRP approval for Ross Nurse Coach Survey CC 2016.pdf	Supplementary Document	Uploaded 2016-11-17	Repair queued
Attachment A Outside Consultants CC 11-3-16.docx	Supplementary Document	Uploaded 2016-11-17	Repair queued
SSA for Ross Nurse Coach Survey CC 11-17-16 FINAL.docx	Supporting Statement A	Uploaded 2016-11-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224457	Online Nurse Coach Survey	Form	New

ICR Details

OMB Control No:	ICR Reference No: 201611-0925-003
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: A National Survey of Nurse Coaches (CC)
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 03/17/2017
	Date Received in OIRA: 11/18/2016
Terms of Clearance: This ICR is being withdrawn from active review while the NIH and OMB determine the applicability of Section 2035 of Public Law No. 114-255 to this Federal collection (21st Century Cures Act, Sec. 2035: Exemption for the NIH from the Paperwork Reduction Act Requirements). At a later time point--after the NIH formally establishes the scope and criteria of collections that fall within the exemption as described in Section 2035--this ICR may be discontinued or re-submitted to OMB for PRA review/approval. At this time, no such determination of the applicability of Section 2035 has been made.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Patient Protection and Affordable Care Act (PPACA) includes specific language addressing health and wellness coaching as a means of “stabilize[ing] chronic medical conditions, such as diabetes and heart disease, thus, preventing hospitalization and physical decline.” While a few research studies have utilized nurses delivering various types of coaching interventions, the role of nurse coach is very new and no published studies have examined the use of nurse coaching in a real world setting. The purpose of this study is to describe the role of Certified Nurse Coaches in order to gain insight into their clinical practice including: the settings in which they work, the types of clients/health conditions they see, the types of client records maintained and outcomes followed, as well as the personal benefits experienced by nurse coaches as a result of becoming a nurse coach.

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Authorizing Statute(s): US Code: 42 USC 285, Section 413 (b)(3) Name of Law: Public Health Service Act
  

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:
	81 FR 56668	08/22/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 81787	11/18/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Online Nurse Coach Survey	1	CC Survey Tool

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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: New submission

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Annual Cost to Federal Government: $960

Does this IC contain surveys, censuses, or employ statistical methods? No

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

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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: 11/18/2016

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