One-Pager Clinical Support Tools Feedback Survey

Request for Approval under the “Fast Track Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0704-0553)

TITLE OF INFORMATION COLLECTION: Clinical Support Tools Feedback Survey

PURPOSE:

In partnership with the Department of Veterans Affairs (VA) Office of Evidence Based Practice and U.S. Army Medical Command (MEDCOM), the Psychological Health Center of Excellence (PHCoE) develops and disseminates Clinical Support Tools (CSTs). CSTs are resources that help healthcare providers deliver evidence-based treatments consistent with the VA and Department of Defense (DoD) Clinical Practice Guidelines. CSTs include educational materials and decision aids for primary and specialty care providers, their patients, and patients’ families.

Currently, PHCoE tracks the number of CSTs that are ordered and downloaded monthly. These numbers are collected from both PHCoE’s and MEDCOM’s websites. While knowing the quantity of ordered and downloaded CSTs is valuable, this metric does not inform on the effectiveness of various CSTs or the cost-effectiveness associated with the creation and maintenance of CSTs. Therefore, a feedback survey has been created to solicit CST user’s opinions on the value and use of various CSTs. Along with the monthly number of ordered CSTs from MEDCOM’s website, MEDCOM also collects end users’ email addresses. We plan to email those who have ordered CSTs from MEDCOM and solicit their voluntary participation in a survey regarding their use of a CST. Data provided by the survey will help answer questions regarding utilization and perception of CSTs.

PHCoE has a memorandum of agreement with MEDCOM and the VA Office of Evidence Based Practice to develop and disseminate CSTs. CSTs are clinical tools which distill information from the clinical practice guidelines of various psychological health issues (i.e., Major Depression, Substance misuse, Insomnia, Suicidality). CSTs help health care providers deliver evidence-based treatments that are consistent with VA and DoD clinical practice guidelines. PHCoE, along with feedback from the VA and MEDCOM, develop CSTs which provide military health system mental health providers and primary care providers with educational materials and decision aids to assist in patient behavioral health care.

CSTs benefit DHA in the following ways:

• Benefits to MHS providers: Help PHCoE create tools that are better suited to providers’ specific needs.

• Benefits to MHS patients and families: Help in the dissemination of behavioral health evidence-based practices and gain valuable information that will help improve CSTs (e.g., are patient guides actually useful or are they too long? What other tools do they want?).

• Benefits to DHA: Determine cost-effectiveness of CSTs; allowing DHA to direct resources to effective projects.

DESCRIPTION OF RESPONDENTS:

Survey respondents will be civilian, contract, and uniform health care providers who are ordering copies of CSTs offered through the Army’s Office of Evidence-Based Practice. Nothing more is currently known about potential survey respondents other than that they will have .mil email address, will have gone to qmo.amedd.army.mil to order a CST, and are likely a military healthcare worker.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [x] Other: Feedback Survey

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Amanda Edwards Stewart, Ph.D., ABPP

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [x] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Contract Psychologists	10	15 minutes	2.5
Totals	10	15 minutes	2.5

PUBLIC COST: The estimated annual cost to the public is $122.5. This takes into account 10 contract psychologists being paid for 15 minutes at a GS-13 rate ($49.00 an hour).

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [x] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Survey respondents will be civilian, contract, and uniform health care providers who are ordering copies of CSTs offered through the Army’s Office of Evidence-Based Practice.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [x] No

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