SEPT 2020 Change Request to Assess Impact of COVID-19 on NBCCEDP Operations

Changes to National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

OMB #: 0920-1046

Expiration Date: 11/30/2021

Background

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) funds 70 state, tribal, and territorial awardees to deliver breast and cervical cancer screening services to low income, under- and uninsured women. The 70 awardees also support implementation of evidence-based interventions (EBIs) within health system clinics to increase breast and cervical cancer screening among clinic populations ages 21-74. Priority populations for these clinic-based interventions include disparate populations ages 50-74 for breast cancer screening and 21-64 for cervical cancer screening.

NBCCEDP Project and Data Collection Summary

• Goal of the study: OMB #0920-1046 has two components: to (1) conduct an annual awardee survey and (2) collect clinic-level data from the 70 NBCCEDP awardees. We are requesting permission to add additional questions to collect systematic information on the effects of COVID-19 on the NBCCEDP.

• Intended use of the resulting data: CDC will use the information to inform interpretation of data currently collected. In particular, the additional questions will inform our understanding of the effects of COVID-19 on program management by the 70 NBCCEDP awardees, clinical service delivery, and EBI implementation in partner health system clinics.

• Methods to be used to collect data:

  • The annual awardee survey collects information about program management, partnerships, screening service delivery network, and technical assistance needs.

  • The baseline and annual clinic-level data from awardees’ health system clinic partners provide information about breast and cervical screening rates, that represents clients ages 50-74 for breast cancer screenings and 21-65 for cervical cancer screenings within partner health systems.

• Analysis: CDC uses descriptive statistics to produce reports for CDC program management and NBCCEDP awardees based on the annual awardee survey and baseline/annual clinic data.

Justification for Changes:

Due to COVID-19, we are requesting approval to add questions that would ascertain the effects of the COVID-19 pandemic and associated mitigation on individual partner health system clinic’s breast and cervical cancer screening rates. These questions will help CDC evaluators to better interpret whether potential decreases in cancer screening delivery and clinic screening rates were due, in part, to COVID-19 or due to other programmatic clinic factors. Specifically, we are requesting to add:

• Seven questions (pages 3-4) to the NBCCEDP awardee survey (Attachment 6). These questions would be the final section with the heading title, “Section 8: COVID-19 Impact”

• Three questions (pages 5-6) to the annual clinic data collection (Attachment 7). These questions would be added to the end of Section 3 with the heading title, “Clinical Characteristics”.

Effect of Proposed Changes on the Burden Estimates:

We anticipate that there will be an increase of 10 minutes for each awardee survey and 5 minutes per clinic data report. Table 1 shows the approved 683 burden hours for this information collection request (page 7). Table 2 shows an estimated 764 burden hours with an overall increase of 81 burden hours. There is an anticipated increase of 11 hours for the NBCCEDP awardee survey and 70 hours for the annual clinic data collection (35 hours for breast cancer and 35 hours for cervical cancer).

Request for Approval

OMB approval is requested effective immediately after the approval. This request is of high priority to the study because the clinics’ annual data for the program year ending June 30, 2019 are due by the end of September 2020.

Proposed COVID-19 Questions for PY3 NBCCEDP Annual Awardee Survey

1. Were any BCCEDP-funded staff deployed to assist on the COVID-19 response during PY3?

Y/N

If Yes, complete this table for each person deployed:

 

Staff person position	Percent FTE time on BCCEDP grant funds (e.g., 50%, 100%)	Percent FTE time deployed (e.g., 50%, 100%)	Length of time deployed in weeks
Example: Data manager	100%	50%	8

1. Were any BCCEDP-funded staff furloughed due to state/organizational budget shortfalls resulting from COVID-19 during PY3?

Y/N

If yes, what dates was the furlough in place during PY3?   XX/XX/XXXX – XX/XX/XXXX

If yes, describe the extent of the furlough?

_____ Days per month

Other: ____________

1. How many of your provider sites that deliver BCCEDP screening and diagnostic services closed for business (i.e., clinic or provider practice closed-down completely) for some amount of time due to COVID-19 during PY3?

   1. None

   2. Some

   3. All

   4. Do not know

 

1. How many of your provider sites that deliver BCCEDP screening and diagnostic services suspended (i.e., temporarily stopped) or reduced breast and/or cervical cancer screening for some amount of time due to COVID-19 during PY3 although the clinic or provider practice remained open?

   1. None

   2. Some

   3. All

   4. Do not know

 

1. Given COVID-19, did your BCCEDP program temporarily stop working with any of your partner clinics that implement evidence-based interventions (EBIs) during PY3 (e.g., temporarily stopped providing TA to these clinics)? 

Y/N

If yes, how many of your partner clinics did you stop working with due to COVID-19 during PY3?

1. Some

2. All

3. Do not know

 

1. During PY3, did your BCCEDP program provide assistance to clinical provider sites or EBI partner clinics as they planned and/or began to “restart” routine clinical care?

Y/N

If yes, please describe:

6. Are there other ways that your BCCEDP program was affected by COVID-19 in PY3? 

Y/N

If yes, please describe:

Proposed COVID-19 Questions for NBCCEDP PY3 Annual Clinic Data Record

1. Did the clinic close or reduce hours at any time during the program year because of COVID-19?

Y/N

If the clinic closed, in total, how long was the clinic closed due to COVID-19 during the program year?

      

• # weeks:

• Other (Specify):

If the clinic did not close but had to reduce hours, how were hours reduced due to COVID-19 during the program year?

 

• ___ hours each day for _____ weeks

• ___ days per week for ______ weeks

• Other (Specify):

2. Did COVID-19 negatively impact the delivery of breast and/or cervical cancer screening and/or diagnostic services during the program year? 

Y/N

              If yes, select all that apply:

• clinic closed for business

• clinic visits suspended or reduced

• clinic visits restricted to sick patients, with limited or no preventive care available

• clinic visits limited to patients at high risk or with symptoms for breast or cervical cancer

• clinic visits were telehealth/telemedicine only

• could not refer average risk patients for mammography due to limited availability of mammography services

• could not refer patients with abnormal mammography or Pap results for follow-up testing due to limited availability of diagnostic services

• Patients cancelled or did not schedule appointments

• Patients fearful of getting COVID-19

• Other (Specify):

3. Did COVID-19 negatively impact the implementation of evidence-based interventions (EBIs) for breast and cervical cancer screening during the program year (e.g., implementation of some or all EBIs were suspended)?       

Y/N

Which EBIs were affected? Check all EBIs impacted.

• Provider assessment and feedback

• Patient reminders

• Provider reminders

• Reducing structural barriers

• Patient navigation

Table 1. Approved Estimated Annualized Burden Hours

Type of Respondent	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hrs)	Total Burden Hours
NBCCEDP Grantees	NBCCEDP Grantee Survey	70	1	45/60	53
	NBCCEDP Clinic-level Information Collection Instrument - Breast	70	6	45/60	315
	NBCCEDP Clinic-level Information Collection Instrument – Cervical	70	6	45/60	315
Total					683

Table 2. Estimated Annualized Burden Hours with Proposed Changes

Type of Respondent	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hrs)	Total Burden Hours	Net Change
NBCCEDP Grantees	NBCCEDP Grantee Survey	70	1	55/60	64	+11
	NBCCEDP Clinic-level Information Collection Instrument - Breast	70	6	50/60	350	+35
	NBCCEDP Clinic-level Information Collection Instrument – Cervical	70	6	50/60	350	+35
Total					764	+81

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