0039 Falls Prevention Supporting Statement - 2021 Final

Administration on Aging, Administration for Community Living
U.S. Department of Health and Human Services
March 11, 2021
Supporting Statement for the
Evidence-Based Falls Prevention Program Standardized Data Collection
A. Justification
1. Circumstances Making the Collection of Data Necessary
Background
This is a renewal, with minor changes, to an existing Information Collection Request.
The Administration on Aging (AoA), part of the Administration for Community Living
(ACL), will use the proposed set of data collection tools to monitor grantees receiving
“Evidence-Based Falls Prevention Programs” cooperative agreements.” Most recently,
through the 2020 Falls Prevention Program funding opportunities, ACL awarded 8
cooperative agreements for a 3-year project period.
Grantee agencies through this program represent a variety of organization types,
including state agencies, universities, and nonprofit organizations. Grantees are tasked
with two primary goals: (1) significantly increase the number of older adults who
participate in evidence-based falls prevention programs; and (2) develop a sustainable
infrastructure for these proven interventions.
The most widely disseminated evidence-based falls prevention programs are A Matter of
Balance, Tai Chi for Arthritis, and Tai Ji Quan: Moving for Better Balance. These
programs have been proven, through rigorous research, to decrease falls and/or falls risk
among older adults.
ACL Falls Prevention grantees currently collect information at both the workshop and
participant level. Specific to the workshop, information on workshop type, site type,
location, start/end date, etc. is collected. At the participant level, de-identified
demographic and health status information is collected prior to workshop participation. A
sample of participants also completes a Post Program Survey to assess whether the
program is achieving its intended outcomes, i.e., reducing falls risk factors and/or
incidence.
AoA funds a National Falls Prevention Resource Center(the “Center”) to provide
technical assistance (TA) to ACL grantees as well as the broader network of
organizations implementing evidence-based falls prevention programs. The Center
developed a database, which grantees and other program sites use to provide data on their
workshops.
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This system allows AoA regular monitoring of grantee performance status, including data
analysis, maps, comparative charts, and identification of high- and low-performing
grantees in order to identify and target TA needs.
Legal and Administrative Requirements
The statutory authority for these cooperative agreements and data collection can be found
in the Consolidated Appropriations Act, 2021, Older Americans Act (OAA) (Section
411); and the Patient Protection and Affordable Care Act, 42 U.S.C. § 300u-11
Prevention and Public Health Fund (PPHF).
Grants financed by the PPHF are accompanied by a high level of transparency, oversight,
and accountability. In April 2012, the U.S. Department of Health and Human Services
(HHS) Division of Grants released an Action Transmittal: FY2012 Appropriations Act
Guidance for the HHS Grants Community noting that all recipients of PPHF awards must
follow HHS guidance related to the tracking, monitoring, and reporting on the use of
PPHF financing. AoA has outlined basic requirements for reporting in the Falls
Prevention Program Announcement and in the Standard Terms and Conditions of
grantees’ notice of awards. These notices require each grantee to prepare and submit
progress reports to AoA that will enable the agency to monitor program performance.
2. Purpose and Use of Information Collection
AoA will use the information from the PPHF Falls Prevention data collection tools to:
1) Comply with reporting requirements mandated by the authorizing statutes;
2) Collect data for performance measures used in the justification of the budget to
Congress and by program, state, and national decision makers;
3) Effectively manage the Falls Prevention program at the federal, state, and local
levels;
4) Identify program implementation issues and pinpoint areas for technical
assistance activities;
5) Identify best practices in program implementation and building sustainable
program delivery systems as well as develop resources to enable current and
future grantees to learn from and replicate these practices; and
6) Provide information for reports to Congress, other governmental agencies,
stakeholders, and to the public about PPHF Falls Prevention grantee progress.
Aggregate data from the PPHF Falls Prevention data collection tools will also be provided to:
federal and state legislators; state agencies; national, state and local organizations with an
interest in evidence-based falls prevention programs and healthy aging issues; current and
future ACL Falls Prevention grantees; and private citizens who request it. Compiled
information will be posted on ACL’s website, as well as the National Fall Prevention
Resource Center’s technical assistance website.
AoA proposes to adapt the previously approved tools that have successfully been used to
monitor the progress of ACL’s prior cohorts of PPHF Falls Prevention grantees. The
following types of tools included in the collection and purposes of each are:
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





Semi-Annual Performance Report Directions and Sample Template will be provided
to grantees to offer additional clarification regarding the performance reporting template
and the type of information that grantees should include in the various sections of the
report to ensure efficient, accurate, and comprehensive reporting.
A Host/Implementation Organization Form will be completed by a staff person at each
new organization hosting and implementing workshops. Basic information, including the
name, location, and type of agency will be obtained and then entered into a national Falls
Prevention database. AoA will use this data on program locations to map the delivery
infrastructure, identify types of agencies involved in program delivery, and to monitor
changes in delivery capacity.
Program data collection tools are paper tools used to collect information at each
workshop/ program series:
o A Program Information Cover Sheet and an Attendance Log are completed by
the workshop leaders/delivery personnel. This information documents the location
of the workshop, type of program, and the number of workshop sessions
completed (in order to monitor whether participants are getting the recommended
intervention dose).
o A Participant Information Form which is completed by each participant on a
voluntary basis. This tool documents participants’ demographic and health
characteristics, such as falls history and falls risk. At the end of each program,
local data entry staff or volunteers will enter information from the Program
Information Cover Sheet and Participant Information Form into the National Falls
Prevention database. The information form has not Personally Identifiable
Information.
o A Post Program Survey which is completed by a sample of participants. This
tool assesses whether the program is achieving its intended outcomes, i.e.,
reducing falls risk factors and/or incidence among participants. At the end of each
program, local data entry staff or volunteers will enter information from the
Program Information Cover Sheet and Participant Information Form into the
national Falls Prevention database. The information form has not Personally
Identifiable Information.
Examples of products developed as a result of current and similar data collection efforts
are available at:
https://www.ncoa.org/center-for-healthy-aging/falls-resource-center/
https://www.ncoa.org/center-for-healthy-aging/cdsme-resource-center/

3. Use of Improved Information Technology and Burden Reduction
The proposed PPHF Falls Prevention data collection tools will use the same procedures
and online data entry system utilized since 2015. The existing national database is
maintained by the National Falls Prevention Resource Center through an AoA
cooperative agreement. Feedback about this system has been very positive. It is
considered very user-friendly. Grantees are not charged any licensing or usage fees to
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access the system. The Center provides training and technical assistance regarding the
use of the system when requested.
4. Efforts to Identify Duplication and Use of Similar Information
There is no similar data collection; all information in the proposed data tools is unique to
the ACL Falls Prevention program grantees.
5. Impact on Small Businesses or Other Small Entities
No small businesses will be involved in this study.
6. Consequences of Collecting the Information Less Frequently
ACL Falls Prevention grantees will submit:



the Semi-Annual Performance Report semi-annually; and
Program Information Cover Sheets, Attendance Logs, and non-personally
identifiable participant data (i.e., Participant Information Form and, for a
sample, the Post Program Survey) on a rolling basis (i.e., as classes conclude).

To meet the statutory requirements for semi-annual reporting and execution of program
management functions, availability of timely data is critical. The project period for
current grantees is 36 months. If data was submitted less frequently throughout the
project period, AoA would be unable to promptly identify grantees in need of technical
assistance to reach their goals (numbers served, numbers of underserved populations
reached, extent to which they are building sustainable systems, etc.). In addition, it is
anticipated that AoA will need to respond to frequent status reports about the use of
Prevention and Public Health Funds.
7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5
No special circumstances apply related to the Guidelines of 5 CFR 1320.5 apply.


Requiring respondents to prepare a written response to a collection of
information in fewer than 30 days after receipt of it;
Not applicable.



Requiring respondents to submit more than an original and two copies of any
document;
Not applicable.



Requiring respondents to retain records, other than health, medical, government
contract, grant-in-aid, or tax records for more than three years;
Not applicable.



In connection with a statistical survey that is not designed to produce valid and
reliable results than can be generalized to the universe of study;
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Not applicable.


Requiring the use of a statistical data classification that has not been reviewed
and approved by OMB;
Not applicable.



That includes a pledge of confidentiality that is not supported by authority
established in statute or regulation, that is not supported by disclosure and data
security policies that are consistent with the pledge, or that unnecessarily
impedes sharing of data with other agencies for compatible confidential use; or
Not applicable.



Requiring respondents to submit proprietary trade secrets, or other confidential
information unless the agency can demonstrate that it has instituted procedures
to protect the information’s confidentiality to the extent permitted by law.
Not applicable.

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8. Comments in Response to the Federal Register Notice and Efforts to Consult
Outside the Agency
As required by 5 CFR 1320.8(d), a 60-day Federal Register Notice (FRN) published in
the Federal Register on September 28, 2020, Volume 85, No. 188, page 60808. AoA also
encouraged current and former PPHF grantees to respond to the Federal Register notice
through a reminder sent out to grantee point of contacts. Several public comments were
received and are summarized and responded to below. A 30-day FRN published on
March 11, 2021 Volume 86, No. 46, pages 13904-13907.
In addition to public comment, feedback on the current forms was sought from the
following internal and external stakeholders:



National Falls Prevention Resource Center and falls prevention subject-matter experts
A grantee focus group (with fewer than 9 participants combined)

Summary of Public Comments
In response to the Federal Registrar Notice, ACL received five emails with comments on
the data collection tools.
A summary of the comments and the ACL response is provided below.
Participant Information Form and Post Survey
Comment

Response

A suggestion was made to add a purpose
statement to the forms to better inform
participants of why this specific data
collection is pertinent.

ACL did not adopt this suggestion. The
purpose of this data collection is multifold – with different benefits and
potential uses of the data by federal,
state, and local stakeholders.

Suggestions were made to make adjustments
to the wording and/or response options for
some of the demographic questions, such as
those related to race, ethnicity, and gender.

ACL did not adopt these suggestions.
The wording and response options for
the demographic questions included
are consistent with OMB-approved
surveys for other ACL programs.
Having this consistency allows ACL
and researchers utilizing this data to
compare outcomes from the population
reached with ACL’s Falls Prevention
Programs to a more broadly
representative population of older
adults.

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For some of the non-demographic questions,
suggestions were made to use different
response options, adjust the wording of the
questions, or use different measurement
scales.

ACL did not adopt these suggestions.
ACL consulted with experts in the
field to identify validated scales to
capture the information needed to
understand the impact of the programs
on critical domains. Adjusting the
wording of the questions would impact
their validity.

1. ACL did not adopt these
Several suggestions were made with respect
suggestions in order to keep the
to the formatting of the forms.
Participant Information Form and
1. Provide a small box on the bottom
Post-Survey to one sheet (front and
right hand corner of each sheet to
back). ACL will be providing the
identify participant ID. Should
surveys to grantees in a Word
paperwork be separated, it provides
format so they can make any
another mechanism to keep forms
formatting edits they deem
complete. Also suggest adding more
necessary, i.e., larger font size,
white space to the document,
more white space, etc.
increasing the space between
questions and answers, and increasing
2. ACL reviewed the bullet point
the font size.
sizes and format of questions to
ensure consistency.
2. There needs to be further consistency
with bullet point sizes and format of
3. ACL revisited the ordering of the
questions. They seem to be
forms to ensure the questions align,
inconsistent.
to the greatest extent possible.
3. To better align the pre- and postsurvey, it might make sense to move
question number 9 on Participant
Information Form closer to question
12.

4. ACL made the spelling correction
to question 7.

4. In question 7, the word “agree,” is
misspelled under “Strongly disagree.”
Some commenters suggested including
definitions of certain terms on the form, for
example, defining what is meant by
“vigorous” or “moderate” exercise.

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ACL did not adopt suggestions to
provide detailed definition of terms
within the questions. Including
definitions would increase the length
of the forms, resulting in greater
participant burden. Local program
coordinators are available to assist
participants completing the forms, in
the event any questions arise with any
of the specific questions.

A suggestion was made to remove the
proposed Question 19 from the Participant
Information Form, with the comment that it
is not relevant pre-program.
A suggestion was made to adjust the wording
of the existing Question 11 (and the response
options) to align with the ACL Chronic
Disease Self-Management Education data
collection forms.

A suggestion was made to expand the
following question on the Participant
Information Form:
“Are you limited in any way in any activities
because of physical, mental, or emotional
problems?”
Suggested replacement questions:
 “Because of a physical, mental, or
emotional condition, do you:
o Have serious difficulty
concentrating, remembering, or
making decisions? Yes, No
o Have difficulty doing errands
alone such as visiting a doctor’s
office or shopping? Yes, No”
 “Do you have serious difficulty walking
or climbing stairs? Yes, No”
 “Do you have difficulty dressing or
bathing? Yes, No”

A commenter suggested adding the following
questions to the forms:



“Are you deaf or do you have serious
difficulty hearing? Yes, No”
“Are you blind or do you have serious
difficulty seeing, even when wearing
glasses? Yes, No”
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ACL adopted this suggestion.

ACL did not adopt this suggestion. The
ACL Falls Prevention and Chronic
Disease Self-Management Education
grant programs are two distinct grant
programs, with two distinct lists of
chronic conditions in their OMBapproved data collections.
ACL did not adopt this suggestion.
This question was only included in the
Participant Information Form, not the
Post Survey. The Participant
Information Form and Post Survey
already include questions to assess
limitations due to physical, mental,
and/or emotional problems, so this
question was deemed duplicative and
removed from the Participant
Information Form entirely to reduce
participant burden.

ACL did not adopt these suggestions to
avoid increasing participant burden
and the length of the forms beyond one
sheet (front and back).



“During the past year, did you provide
regular care or assistance to a friend or
family member who has a long-term
health condition or disability?”

Fall Prevention Coversheet
Comment

Response

Some commenters suggested not requiring a
separate Program Information Coversheet –
instead folding some of the questions in the
coversheet into the Participant Information
Form, Post-Survey, and/or the semi-annual
grantee report.

ACL did not adopt this suggestion. The
grantee focus group reported that this
form was useful for organizing their
data collection and program delivery.
Adding questions to the Participant
Information and Post-Survey would
also increase their length beyond 1
sheet (front and back).

A commenter provided the following
formatting-related comments:

ACL adopted these edits.



The dotted lines dictating the start
year appear to be missing – suggest
adding these; and



suggest adjusting the bullet sizes to
be consistent, specifically in question
number 7, the bullet under indicating
“other,” is different from the
previous bullet

A commenter suggested adding a space to
note host/implementation organization.

ACL did not adopt this suggestion.

A commenter suggested adding check boxes
to note if the program was delivered in a
remote format.

ACL did not adopt this suggestion due
to variability in how remote programs
are defined and delivery format.

Host/ Implementation Organization Form
Comment
A commenter suggested adding to Question
2 the statement, “Please check only if you
are a new ______
Host Organization
_____ Implementation Site.”

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Response
ACL did not adopt this suggestion. The
purpose of this form is to document
new host organizations and
implementation sites, so these

additional instructions were deemed
unnecessary.
Fall Prevention Attendance Log
Comment

Response

One commenter suggested using an “X”
ACL adopted this suggestion.
(rather than fill in the box) to denote sessions
attended.
One commenter noted that “the last blank for
‘end date’ is not bolded”.

ACL made this correction.

One commenter suggested changing the form ACL adopted this suggestion.
to landscape to account for length of Tai Chi
and Enhance Fitness programs.
Comment relevant to all forms:
Comment

Response

One commenter suggested that ACL provide
fillable PDF forms.

ACL will be providing the documents
in Word format. If resources allow, we
will also provide fillable PDFs for
grantee use.

9. Explanation of any Payment or Gift to Respondents
Not applicable. There will be no payments or gifts to the respondents.
10. Assurance of Confidentiality Provided to Respondents
There are no assurances of confidentiality. Individuals and organizations’ are told the
purposes for which the information is collected and data is not used or disclosed for any
other purpose. Using a standardized script, workshop leaders inform respondents
responses on surveys are for statistical purposes only. There are no identifying
information such as name, zip code, birth date, etc. as part of this information collection.
11. Justification for Sensitive Questions
This project includes questions that may be considered sensitive. The revised Participant
Information Survey requests health status, type of chronic condition(s), and
demographic characteristics, such as race.
The Post Program Survey requests information related to health status and related
changes in falls risk/and or incidence. These data elements are necessary to determine the
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extent to which grantees are serving the intended populations. ACL/AoA protects all data
to the fullest extent possible by using encrypted, password protected data files.
12. Estimates of Annualized Burden Hours and Costs
12A. Estimated Annualized Burden Hours
Grantee project staff
An estimated 20 PPHF Falls Prevention grantees will enter data into the database. On a
semi-annual basis, 20 lead project staff will submit progress reports. On average, the
estimated burden is eight hours per semi-annual report or 16 hours annually, totaling
about 320 annual burden hours for grantee staff.
Leaders, Local Data Entry, and National Database Data Entry staff
The PPHF Falls Prevention grantees are expected to offer approximately 872
workshops/course series/programs annually, conducted by about 436 local agency
leaders/coaches who average teaching about two programs per year. These programs will
be sponsored by approximately 436 host organizations. A local staff person at each new
host organization will complete a host organization form. On average, each of the 20
funded states will be expected to have two data entry persons for a total of 40.
The expected burden on the 436 local agency leaders is 0.5 hours per program times two
programs per year (with a total burden of 436 hours) to complete the Program
Information Form, record attendance on the Attendance Log, and explain and collect the
Participant Information Forms and Post Program Surveys.
The 40 local data entry staff will be expected to enter data from approximately 872
programs, including the Program Information Forms, Participant Information Surveys,
and Post Program Surveys with an average burden of 0.50 hours per workshop or a total
annual burden of 436 hours.
Local organization staff will complete the Host/Implementation Organization forms.
Their expected burden is .05 hours per form x 436 organizations or a total annual burden
of approximately 22 hours. A database entry staff person at the national database will
enter data from the Host/Implementation Organization forms. The costs of this person’s
time are included in the Federal contract cost (with the ACL National Falls Prevention
Resource Center) and are therefore not included in the estimates of Total Burden Hours.
Participants
It is anticipated that the ACL/AoA grantees will reach about 10,455 program participants
annually. Each participant will be asked to complete the Participant Information Survey
on a voluntary basis before or at the beginning of the first program session and a sample
will be asked to complete the Post Program Survey on a voluntary basis at the end of the
last session. The estimated burden on each participant for the Participant Information
Survey is 0.10 hours x 10,455 for a total burden of 1,046 hours. The estimated burden for
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the Post Program Survey is 0.10 hours x 6,273 (OMB-approved 60% random participant
sample) for a total burden of approximately 628 hours.

Total Burden Hours
ACL/AoA estimates that the total number of burden hours for project staff, local staff and
volunteers, data entry personnel, and program participants is 4,345 hours. The burden
hours per form and respondent are summarized in Exhibit 1.
Type of
Respondent

Form
Name

Estimated
Number of
Number of
Responses
Respondents Per
Respondent

Project staff

Semi-annual
Performance Report
Program Information
Cover Sheet /
Participant Information
Form/ Attendance Log/
Post Program Survey

20

Host/Implementation
Organization Form

Participant Information
Form
Post Program Survey

Local agency
leaders

Local data
entry staff

Local
organization
staff and
local
database
entry staff
Program
participants
Program
participants

Average
Time per
Response
(in
hours)
8

Total
Burden
Hours
(Annual)
320 hours

436 staff

Twice a
year
Twice a
.50
year (one set
per
program)
Once per
.50
program x
872
programs
1
.05

10,455

1

.10

1,046 hours

6,273

1

.10

628 hours

436 leaders

40 data entry
staff

Total Burden Hours

436 hours

436 hours

22 hours

2,888*

*Number rounded up to the nearest hour
12B. Costs to Respondents
The annualized cost burden for respondents is estimated to be $79,909. Exhibit 2 shows the
estimated annual cost burden to each type of respondent, based on their time to complete the data
collection tools. The hourly rate for the project staff, local leaders, and local data entry staff is
based upon the average wages of similar professions published by the Department of Labor,
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Bureau of Labor Statistics. The hourly rate for the participants was based on average Social
Security monthly benefits.

Exhibit 2: Estimated annualized cost burden
Type of Respondent Total Burden Hourly Wage
Hours
Rate
Project Staff
320
$ 97.101
Local Agency
436
$45.102
Leaders
Local Data Entry
436
$32.743
Staff
Participants
1,674
$8.904
*Rounded to the nearest dollar

Annual Cost
$31,072
$19,663.60
$14,274.64
$14,898.60
Total Annual Costs: $79,909*

13. Estimates of Other Total Annual Cost Burden to Respondents or Record Keepers
There are no other costs to respondents or record-keepers or capital costs.
14. Annualized Cost to the Federal Government
AoA Project Officers will review the semi-annual reports and national compiled data.
The total Federal staff burden hours spent reviewing and analyzing the program data are
estimated to be 150 hours annually at an average salary rate of $49.685 per hour for a
total of $7,452. In addition, ACL funds the management of the ACL Falls Prevention
Program Database through an agreement with the National Falls Prevention Resource
Center.

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Medical and Health Services Managers.
Hourly wage of $48.55, plus a factor of 100% ($48.55) to account for benefits and overhead. Wage information available at:
https://www.bls.gov/ooh/management/medical-and-health-services-managers.htm (visited February 18, 2021).
1

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Health Educators and Community Health
Workers. Hourly wage of $22.55, plus a factor of 100% ($22.55) to account for benefits and overhead. Wage information available
at: https://www.bls.gov/ooh/community-and-social-service/health-educators.htm (visited February 18, 2021).
2

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, General Office Clerks,
Hourly wage of $16.37 plus a factor of 100% ($16.37) to account for benefits and overhead. Wage information available at:
https://www.bls.gov/ooh/office-and-administrative-support/general-office-clerks.htm (visited February 18, 2021).
3

4

Social Security Administration, Social Security Monthly Statistical Snapshot, February 2021, Accessed February 18, 2021 from
http://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/.
5

Federal staff costs based on 2021 hourly wage rate of $49.68 for a Project Officer at the GS 13-1 level. A factor of 100% or
$7,722, has been added to the base of $7,722 to account for benefits. https://www.opm.gov/policy-data-oversight/payleave/salaries-wages/salary-tables/pdf/2021/DCB_h.pdf. Accessed February 18, 2021.

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$14,9045
$150,000

Federal staff oversight
Annual Database Support
TOTAL: $164,904

15. Explanation for Program Changes or Adjustments
There is a program change annual burden decrease of -1456 annual hours.
ACL/AoA received the following feedback on the information collection:




National Falls Prevention Resource Center subject-matter experts
A grantee focus group (with less than 9 participants combined)
Public comments (during 60-day Federal Registrar period)

16. Plans for Tabulation and Publication and Project Time Schedule
Data will be due semi-annually and reviewed by AoA project officers and technical assistance
liaisons at the Falls Prevention Resource Center. If inconsistencies are noted, grantees will be
asked to correct and resubmit their reports. Once all reports are verified, the data will be
aggregated and analyzed by AoA and the Falls Prevention Resource Center liaison. Based on
previous data collections, this process will take about one month after each progress report.
When the data is finalized, aggregate information will be posted on the AoA and Falls
Prevention Resource Center websites, both of which are available to the public. The Falls
Prevention Resource Center will provide AoA and grantees access to the data in charts, graphs,
and other summaries depicting the national data and each grantee’s data.
17. Reason(s) Display of OMB Expiration Date is Inappropriate
Not applicable.
The OMB expiration date will be displayed on all data collection instruments.
18. Exceptions to Certification for Paperwork Reduction Act Submissions
There are no exceptions to the certification.

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