0298 MCHB DGIS Change Memo

DATE: September 24, 2019

TO: Quinn Hirsch, OMB Desk Officer

FROM: Lisa Wright-Solomon, HRSA Information Collection Clearance Officer

_____________________________________________________________________________

Request: The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau requests approval for non-substantive changes to the Maternal and Child Health (MCH) Jurisdictional Survey (OMB #0906-0042, expires 04/30/2022). The survey consists of 1) a core MCH Jurisdictional Survey Questionnaire and 2) Jurisdiction-Specific Survey Questionnaires.

Purpose: The proposed adjustments to select survey questions as outlined below will better align the data collected for National Performance Measures (NPM) 7 and 9 with other federally available data sources. In addition, the translated surveys for the Marshall Islands (Marshallese) and the Federated States of Micronesia (Pohnpeian), clarifications to enumerator instructions, as well as the updated versions of all English and previously translated surveys are attached to reflect the proposed changes.

Time Sensitivity: The MCH Jurisdictional Survey has just completed the first round of data collection with four of the eight jurisdictions (American Samoa, Guam, Palau and US Virgin Islands). Data from the remaining four jurisdictions (Marshall Islands, Federated States of Micronesia, Northern Mariana Islands and Puerto Rico) will be collected between November 2019 and January 2020. The proposed changes must be incorporated before data collection begins in November 2019 to ensure that data can be reflective of NPMs for all remaining jurisdictions.

Burden: The original estimated survey completion time was 45 minutes; however, the average survey completion time in American Samoa, Guam, Palau, and US Virgin Islands is reported at 36 minutes. The proposed edits to the survey questions add no more than 1.5 minutes. Therefore, the revisions included herein do not change the estimated reporting burden since the adjusted survey completion time falls within the originally projected estimate of 45 minutes.

PROPOSED EDITS TO THE MCH JURISDICTIONAL SURVEY:

1. MCH Jurisdictional Survey D12 – Revision
   The goal of the revised question is to improve data collection for NPM 7 (rate of hospitalization for non-fatal injury per 100,000 children, ages 0 to 9; and rate of hospitalization for non-fatal injury per 100,000 children, ages 10 to 19). The current language could infer visits to the emergency room related to illness and/or injury.

Rationale: Currently, data to support NPM 7 in regards to injury-related hospital visits, specifically, are unable to be derived from question D12. The adjustment of the language and integration of a two-step question will provide clarification to the question’s intended definition of “injury” and will ensure that the jurisdictions are able to use data to report on NPM 7.

2. MCH Jurisdictional Survey – Addition
   Currently, this two-step question reports on National Performance Measure 9 (percent of adolescents, ages 12 through 17, who are bullied or bully others) and is included in the jurisdictional-specific modules for American Samoa, Northern Mariana Islands, Palau, and Puerto Rico, only. The question will be added to the Core MCH Jurisdictional Survey to ensure reporting across all Jurisdictions, which includes Guam, USVI, Federal States of Micronesia, and the Republic of Marshall Islands.

Rationale: Considering that bullying is a public health concern across all jurisdictions, it is recommended to move the question the Core MCH Jurisdictional Survey to ensure that data is collected for all jurisdictions.

3. MCH Jurisdictional Survey L18 – Clarification
   The skip instructions for the enumerator related to survey question L18 needs to be clarified. Currently, question L18 instructs the enumerator to skip Zika virus-related questions, if the respondent indicates that she is not pregnant. This results in missing data on children 12 months or younger related to the Zika virus.
   
   Rationale: The adjustment of the enumerator instructions will ensure that Zika virus-related questions are asked for all children 12 months and younger, regardless of current pregnancy status of the mother.

4. Updated Translated Surveys– American Samoa, Palau and Puerto Rico

The translated version for American Samoa (Samoan), Federated States of Micronesia (Chuukese), Guam (Chuukese and Tagalog), Palau (Palauan and Tagalog), Puerto Rico (Spanish) and US Virgin Islands (Spanish) must be updated to reflect the proposed edits to the MCH Survey as detailed in Sections 2 , 3, and 4 above.

Rationale: In order to ensure that the highest number of respondents are reached, translations were completed in the native languages and must be updated to reflect the proposed edits to the survey.

5. Additional Translated Surveys– Republic of the Marshall Islands and Federated States of Micronesia
   The translated version for the Marshall Islands (Marshallese) and the Federated States of Micronesia (Pohnpeian) are used to reach members of the population that speak these native languages.
   
   
   

Rationale: In order to ensure that the highest number of respondents are reached, additional translations must be completed in the native languages.

Attachments:

1. Updated MCH Survey_ AS_English

2. Updated MCH Survey_ FSM_English

3. Updated MCH Survey_ Guam_English

4. Updated MCH Survey_ RMI_English

5. Updated MCH Survey_ CNMI_English

6. Updated MCH Survey_ Palau_English

7. Updated MCH Survey_ PR_English

8. Updated MCH Survey_ USVI_English

9. Updated MCH Survey_ American Samoa_Samoan

10. Updated MCH Survey_ FSM_Chuukese

11. Updated MCH Survey_ Guam_Chuukese

12. Updated MCH Survey_ Guam_Tagalog

13. Updated MCH Survey_ Palau_Palauan

14. Updated MCH Survey_ Palau_Tagalog

15. Updated MCH Survey_ PR_Spanish

16. Updated MCH Survey_ USVI_Spanish

17. New Translations (Marshallese):

    1. MCH Survey Eligibility and Consent Script_ Marshallese

    2. MCH Survey Consent_Leave-Behind Consent_ Marshallese

    3. MCH Survey_ RMI_Marshallese Aug 2019

18. New Translations (Pohnpeian):

    1. MCH Survey Eligibility and Consent Script_ Pohnpeian

    2. MCH Survey_Leave-Behind Consent_ Pohnpeian

    3. MCH Survey_ FSM_Pohnpeian

All proposed changes are indicated with tracked changes in the attached documents.

Requested Changes to Maternal and Child Health Jurisdictional Survey Questionnaire (OMB #0906-0042, expires 04/30/2022), Page 3