Request for Change

Change Request

Proposed changes to the Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Facilities in the U.S. and Territories

(OMB Control No. 0920-0743 Exp. Date 10/31/2021)

January 16, 2020

Summary

The Centers for Disease Control and Prevention (CDC) requests OMB approval for nonmaterial/non-substantive changes to the OMB approved information collection instrument, the mPINC Survey Instrument. Specifically, the CDC requests OMB approval for minor edits to improve clarity of select mPINC survey items, specifically items A1, A11, E1, E4, F3, F4, and G3 for the 2020 mPINC Facility Survey.

Attachments

• Attachment 6c - mPINC Facility Survey 2018 (version with track changes)

• Attachment 6c - mPINC Facility Survey 2020 (version incorporating proposed edits)

Background and Justification

The Maternity Practices in Infant Nutrition and Care (mPINC) Facility Survey is a national census of hospitals routinely providing maternity care in the United States and Territories conducted by the CDC. The resulting data provide timely and specific, action-oriented information (facility-specific Benchmark Reports) to participating hospitals in the United States and Territories, and provide aggregated state data to a wide spectrum of state-level stakeholders (state-specific State Reports).

OMB approved CDC to conduct planned mPINC facility surveys in 2018 and 2020. The CDC has completed the administration of the 2018 mPINC Facility Survey, and based on lessons learned during the 2018 administration, CDC requests OMB approval for nonmaterial/non-substantive changes to improve clarity of select mPINC survey items (see Table 1 below). Purple text indicates hovers with mouse-over text.

CDC is requesting only a few minor changes to the mPINC Facility Survey Instrument to provide clarification for respondent hospitals. The table below lists the sections and item number to be edited. If approved, these edits will be incorporated into the 2020 mPINC Facility Survey instrument.

There are no proposed changes for other sections of the mPINC Facility Survey Instrument including: Section B. Special Care Nursery and/or Neonatal Intensive Care Unit; Section C. Care Practices; or Section D. Feeding Practices.   

Table 1. List of Changes by Section and Item Number to the 2020 mPINC Facility Survey

Section	Previously Approved Text	New Text	Reason for Change
Section A. Hospital data (item A1)	What type of facility is your hospital? (select 1 option only) Government hospital Non-profit hospital Private hospital Military hospital	What type of facility is your hospital? (select 1 option only) Government (public, non-military) hospital Non-profit, private hospital For profit, private hospital Military hospital	Add descriptors to answer options to improve clarity of hospital type and make the categories mutually exclusive
Section A. Hospital data (Item A11)	How many newborns diagnosed with Neonatal Abstinence Syndrome (NAS)… Answer option: …are cared for in your specialty unit (Special Care Nursery, Neonatal Intensive Care Unit, Regional Neonatal Intensive Care Unit)?	How many newborns diagnosed with [Neonatal Abstinence Syndrome (NAS)] (whose mothers have NOT yet been discharged from the hospital)… Answer option: …are cared for in your hospital’s Neonatal Intensive Care Unit (NICU)? Mouse-over text: Neonatal Abstinence Syndrome (NAS): “A newborn with confirmed or suspected in utero exposure to opioids, benzodiazepines, or barbiturates. Please see the “CSTE Neonatal Abstinence Syndrome Standardized Case Definition.”	Add text to clarify the question stem Add a hover to clarify the definition of NAS Edit one answer option to simplify information collected. Add the definition of NAS in the mouse over text,
Section E. Education and Support of Mothers (item E1)	How many mothers and support persons are taught strategies for [safe sleep] with their newborn at the hospital (regardless of feeding method)? Mouse-over text: Safe sleep: Infants are placed on their backs on a firm, flat surface that is free of any items.	To prevent newborn adverse events (e.g., infant falls, accidental suffocation) associated with maternal sleep in the hospital, how many mothers are shown by staff how to place their newborn on a separate, [safe sleep] surface or with another caregiver when the mother becomes sleepy/drowsy?  Mouse-over text: Safe sleep: infants are placed on their backs on a firm, flat surface (e.g., bassinet) that is free of any items and will prevent infant falls.	Edit the question stem to clarify that the item is related to safe sleep when the mother becomes sleepy/drowsy in the hospital Text has been added to the mouse-over to clarify the definition of safe sleep to include will prevent infant falls
Section E. Education and Support of Mothers (item E4)	Among mothers whose newborns are fed any formula, how many are taught…how to safely prepare and feed formula?	Among mothers whose newborns are fed any formula, how many are taught…how to [safely prepare and feed] formula? Mouse-over text: Safely prepare and feed: Instructions for mixing, handling, and storing infant formula	Add a hover to the answer option “safely prepare and feed” Add the definition of safely prepare and feed in the mouse-over text
Section F. Staffing (item F3)	How often are nurses [formally assessed] for clinical competency in breastfeeding support and lactation management? At least once per year Less than once per year Not required	Question F3. How often are nurses [formally assessed] for clinical competency in breastfeeding support and lactation management? At least every 2 years Less frequently than every 2 years Not required	Modify the answer options to clarify timing of formal assessment of nurse’s clinical competency
Section F. Staffing (item F4)	Are nurses required to demonstrate competency in the following skills? …counseling the parents/caregivers on [safe sleep] practices for their newborn during the hospital stay. Mouse-over text: Safe sleep: infants are placed on their backs on a firm, flat surface (e.g., bassinet) that is free of any items.	Are nurses required to demonstrate competency in the following skills? …counseling the parents/caregivers on [safe sleep] practices for their newborn during the hospital stay. Mouse-over text: Safe sleep: infants are placed on their backs on a firm, flat surface (e.g., bassinet) that is free of any items and will prevent infant falls.	Add text to the mouse over to provide a definition of safe sleep to include prevent infant falls(e.g., bassinet)
Section G. Policies and Procedures (item G3)	How many health care providers who have any contact with pregnant women, mothers, and/or newborns have been oriented on the hospital’s infant feeding policies? Answer option: Our hospital does not have official infant feeding practice policies.	How many health care providers who have any contact with pregnant women, mothers, and/or newborns have been oriented on the hospital’s infant feeding policies? Answer option: Our hospital does not have written policies related to infant feeding practices.	Edit answer option to clarify that the answer refers to written policies

Effect of Proposed Changes on the Burden Estimate

No changes are anticipated in estimated annualized burden hours to respondents to complete the mPINC Facility Survey due to the nonmaterial/non-substantive changes, as provided in the 2018 OMB review, and presented below in Table 2.

Table 2. Estimated Annualized Burden Hours

Type of Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hr)	Total Burden Hours (in hr)
Maternity hospitals	mPINC Facility Survey	1,421	1	30/60	711

Effect of Proposed Changes on Currently Approved Instruments and Attachments

The following table describes the attachments which have been updated as a result of nonmaterial/non-substantive changes to select items on the mPINC facility survey instrument. Edits are shown in track changes (red text) in the file titled, Attachment 6c_mPINC Facility Survey 2018, and Attachment 6c_mPINC Facility Survey 2020 is a clean version with track changes accepted.

Table 3. Effect of Proposed Changes on the Currently Approved Instrument and Attachment

Previous Attachment IC Title	Change Request Attachment Title
Attachment 6c_mPINC Facility Survey 2018	Attachment 6c_mPINC Facility Survey 2020