4036 Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: 

‘‘Assessing the Feasibility of 

Disseminating Effective Health Center 

Products through Mobile Phone 

Applications.’’ In accordance with the 

Paperwork Reduction Act, 44 U.S.C. 

3501–3521, AHRQ invites the public to 

comment on this proposed information 

collection. 

This proposed information collection 

was previously published in the Federal 

Register on November 15th, 2011 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by February 27, 2012. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at OIRA_submission@omb.eop.

gov (attention: AHRQ’s desk officer). 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@AHRO.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Assessing the Feasibility of 

Disseminating Effective Health Center 

Products Through Mobile Phone 

Applications 

The Agency for Healthcare Research 

and Quality (AHRQ) requests that the 

Office of Management and Budget 

(OMB) approve, under the Paperwork 

Reduction Act of 1995, this collection of 

information from users of work products 

and services initiated by the John M. 

Eisenberg Clinical Decisions and 

Communications Science Center 

(Eisenberg Center). 

AHRQ is the lead agency charged 

with supporting research designed to 

improve the quality of healthcare, 

reduce its cost, improve patient safety, 

decrease medical errors, and broaden 

access to essential services. AHRQ’s 

Eisenberg Center’s mission is improving 

communication of findings to a variety 

of audiences (‘‘customers’’), including 

consumers, clinicians, and health care 

policy makers. The Eisenberg Center 

compiles research results into useful 

formats for customer stakeholders. The 

Eisenberg Center also conducts 

investigations into effective 

communication of research findings in 

order to improve the usability and rapid 

incorporation of findings into medical 

practice. The Eisenberg Center is one of 

three components of AHRQ’s Effective 

Health Care (EHC) Program. The 

collections proposed under this 

clearance include activities to assess the 

feasibility of using specific media and 

awareness-raising processes to 

encourage consumers who are at risk for 

selected health problems for which EHC 

Program materials are available to 

access information about such materials 

using mobile phone technologies. The 

project will specifically focus on 

promoting awareness of eight consumer 

guides developed through the EHC 

Program. The guides are all published in 

English and Spanish-language versions. 

All of the guides are designed to help 

decision makers, including clinicians 

and health care consumers, use research 

evidence to maximize the benefits of 

health care, minimize harm, and 

optimize the use of health care 

resources. 

The project will test the feasibility of 

using mobile telephone technology for 

the dissemination of EHC Program 

materials to underserved health 

consumer populations using: (a) Short 

message services (SMS), usually referred 

to as texting, that can be provided to 

people with basic cell phone service 

and texting support; and (b) mobile Web 

access that provides access to the 

Internet via a mobile interface. 

Different methods and/or vehicles 

will be used to promote awareness of 

opportunities to obtain cell phone- or 

smart phone-based information about 

the availability of EHC Program 

materials including: (1) Wall posters in 

patient service areas of the three (3) 

participating clinics; (2) flyers about the 

products distributed in magazine racks 

and through patient kiosks in some 

areas of the clinics; (3) flyers/ 

announcements given to patients at 

checkout from the clinic; and (4) health 

fairs convened to address general health 

issues, where the information can be 

provided. Promotional materials will 

invite potential users to send a specific 

text message with the keyword 

associated with the relevant health 

condition to the advertised number. 

Subjects will receive a response text 

with a brief message about the condition 

and an invitation to either (a) request a 

printed consumer guide or (b) access the 

mobile Web site to view the guide. 

This project has the following goals: 

(1) Summarize marketing efforts in 

terms of total numbers of posters, flyers, 

and information sheets distributed 

through specific venues (e.g., patient 

waiting areas, patient check-out 

processes) and numbers of individuals 

contacted through health fairs and 

related activities; 

(2) Summarize the extent to which 

persons in targeted patient populations 

responded to marketing efforts; 

(3) Assess patient satisfaction with: (a) 

The means by which patients were 

alerted as to the availability of EHC 

Program materials; (b) the methods 

patients used to request and access the 

EHC Program materials; and (c) the 

value and relevancy of the information 

that they obtained; 

(4) Characterize perceptions of 

clinical care providers and clinical staff 

persons in terms of: (a) The value of 

efforts to promote patient awareness of 

EHC Program materials using marketing 

techniques described in this feasibility 

project; and (b) the effect of these efforts 

on workflow issues and related aspects 

of clinic operations. 

This study is being conducted by 

AHRQ through its contractor, the 

Eisenberg Center—Baylor College of 

Medicine, pursuant to AHRQ’s statutory 

authority to conduct and support 

research, and disseminate information, 

on healthcare and on systems for the 

delivery of such care, including 

activities with respect to both the 

quality, effectiveness, efficiency, 

appropriateness and value of healthcare 

services and clinical practice. 42 U.S.C. 

299a(a)(1) and (4). 

Method of Collection 

To achieve the goals of this project the 

following data collections will be 

implemented: 

(1) Focus Groups with Clinicians. A 

focus group will be conducted at each 

of the three participating clinics during 

regularly scheduled internal clinic 

meetings, to determine how the 

introduction of marketing materials and 

related resources influenced, if at all, 

delivery of care in the clinical settings. 

Special emphasis will be placed on 

determining if introduction of the 

project materials changed the ways in 

which patients interacted with 

clinicians. It is expected that each focus 

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Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 4037 

group will include no more than 10 

clinical professionals (e.g., physicians, 

physician assistants, nurses and nurse 

practitioners, pharmacists). 

(2) Focus Groups with Support Staff. 

A focus group will be conducted with 

support staff working in each of the 

three participating clinics, during 

regularly scheduled meetings, to 

determine if the introduction of the 

project materials altered clinic 

workflows. It is expected that each focus 

group will include no more than 12 

support staff (e.g., receptionists, nursing 

assistants, other personnel who interact 

with patients). 

(3) Patient Interviews. In-person 

interviews conducted immediately after 

the patient exits the clinic will be used 

to determine if patients: (a) Saw and 

understood the marketing materials 

(e.g., posters and flyers) in clinic 

settings; (b) were encouraged by the 

marketing materials to text and request 

information about their health issue(s); 

(c) could identify specific reasons why 

they did or did not text; and (d) have 

suggestions about how marketing 

materials might be changed so that they 

would be more likely to encourage 

patients like themselves to text. 

(4) Feedback Questionnaire for 

Patients Requesting Mailed Guides. All 

persons that respond to the marketing 

materials by requesting any of the eight 

guides to be mailed to them will be 

asked to complete a brief paper 

questionnaire included with the guides. 

The purpose of the questionnaire is to 

assess the extent to which the guides 

were easy to read and understand, 

whether the guides provided the 

information they sought, and any 

suggestions for improving and 

delivering the guides. 

(5) Feedback Questionnaire for 

Patients Visiting the Mobile Web Site. 

All persons that access the guides via 

the mobile Web site will be asked to 

complete a brief online questionnaire. 

Only subjects exposed to the promotion 

materials will receive the address of the 

mobile Web site during the text message 

conversation, and therefore we expect 

no other individuals to visit this site. 

The purpose of the questionnaire is to 

determine if the guides were useful, the 

mobile Web site was easy to use, 

whether they found the information 

they needed and experienced any 

difficulty in accessing the guides 

through their cell phone. 

(6) Usage Log Data. Data from 

automated electronic log systems will be 

collected from two sources: (1) Mobile 

Commons, the contractor that manages 

the cell phone-related message delivery 

and cell phone-based communication; 

and (2) the Eisenberg Center at Baylor 

College of Medicine that manages the 

EHC Web site visits. Usage log data 

gathered from the cell phone service 

contractor will include: (1) Counts of 

text messages received from persons 

requesting information about consumer 

guides; (2) the distribution of message 

counts across originating clinics tracked 

through the use of distinctive call-in or 

short code numbers assigned to each 

clinic; and (3) the numbers and 

originating clinic-specific distributions 

of follow-up texts Because text 

communications will be date and time 

stamped, Eisenberg Center staff will be 

able to calculate mean durations in time 

from receipt of the initial messages and 

follow-ups, which may be useful in 

determining navigation patterns and 

suggesting connectivity barriers. Usage 

log data gathered from the mobile Web 

site will allow for identification of: (1) 

The number of visitors that originate 

from a specific uniform record locator 

(URL) associated with each clinic; (2) 

the duration of visits to the EHC Web 

site to gather desired information and 

explore other resources available 

through the Web site; (3) the number of 

pages viewed by each visitor; and (4) the 

number of downloads of the full report 

associated with each guide, which will 

also be made available. These data will 

be obtained using automated systems 

already in place, and no special effort 

will be needed to generate these data; 

this task is not included in the burden 

estimates in Exhibit 1 below. 

The Eisenberg Center will determine 

the feasibility of this approach to 

encouraging patients and anyone else 

viewing the marketing materials to 

access information that may be helpful 

to them in understanding health care 

choices and engaging more fully in their 

own health care, and whether this 

approach should be pursued further. 

This information will be used to 

determine the feasibility of: (a) 

Mounting broader efforts to distribute 

consumer guides, as well as other EHC 

Program products, using mobile 

technologies as tools to heighten 

awareness of these resources by 

potential users who rely on mobile 

communication devices for information 

access; and (b) initiating additional 

studies to identify factors that encourage 

or deter effective use of increasingly 

pervasive communication modalities 

(e.g., cell phones, smart phones) in 

communicating with care providers and 

others and to access information from 

the Internet and health-related Web 

sites. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden for the respondents’ 

time to participate in this research. 

Focus groups will be conducted with 

about 10 clinicians per each of the 3 

participating clinics (30 total) and about 

12 clinical support staff per clinic (36 

total), and will last 45 minutes. 

Interviews will be conducted with about 

100 patients per clinic (300 total) upon 

exit from the clinical visit, with each 

interview lasting about 15 minutes. The 

Feedback Questionnaire for the Mailed 

Guides will be completed by 

approximately 200 persons and will 

take 10 minutes to complete and the 

Feedback Questionnaire for the Mobile 

site will be completed by about 200 

persons and also requires 10 minutes to 

complete. The total annual burden is 

estimated to be 191 hours. Exhibit 2 

shows the estimated annualized cost 

burden associated with the respondent’s 

time to participate in this research. The 

total annual cost burden is estimated to 

be $5,320. 

EXHIBIT 1—ESTIMATED ANNUALIZED TOTAL BURDEN HOURS

Type of data 

collection 

Number of 

respondents per 

respondent 

Number of 

responses 

Hours per 

response 

Total 

burden hours 

Focus Groups with Clinicians .......................................................... 30 1 45/60 23 

Focus Groups with Support Staff .................................................... 36 1 45/60 27 

Patient Interviews ............................................................................ 300 1 15/60 75 

Feedback Questionnaire for Patients Requesting Mailed Guides .. 200 1 10/60 33 

Feedback Questionnaire for Patients Visiting Mobile Web site ...... 200 1 10/60 33 

Total .......................................................................................... 766 na na 191 

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4038 Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 

EXHIBIT 2—ESTIMATED ANNUALIZED TOTAL COST BURDEN

Type of data 

collection 

Number of 

respondents 

Total 

burden hours 

Average 

hourly wage 

rate * 

Total 

cost burden 

Focus Groups with Clinicians .......................................................... 30 23 $83.59 $1,923 

Focus Groups with Support Staff .................................................... 36 27 14.31 386 

Patient Interviews ............................................................................ 300 75 21.35 1,601 

Feedback Questionnaire for Patients Requesting Mailed Guides .. 200 33 21.35 705 

Feedback Questionnaire for Patients Visiting Mobile Web site ...... 200 33 21.35 705 

Total .......................................................................................... 766 191 na 5,320 

* Based upon the mean wages for clinicians (29–1062 family and general practitioners), clinical team members (31–9092 medical assistants) 

and consumers (00–0000 all occupations), National Compensation Survey: Occupational wages in the United States May 2010, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ 

Estimated Annual Costs to the Federal 

Government 

The maximum cost to the Federal 

Government is estimated to be $203,531 

annually. Exhibit 3 shows the total and 

annualized cost by the major cost 

components. 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost Annualized cost 

Project Development ....................................................................................................................................... $146,175 $73,088 

Data Collection Activities ................................................................................................................................. 85,425 42,713 

Data Processing and Analysis ......................................................................................................................... 65,375 32,688 

Project Management ........................................................................................................................................ 47,588 23,794 

Overhead ......................................................................................................................................................... 62,500 31,250 

Total .......................................................................................................................................................... 407,063 203,531 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, comments on AHRQ’s 

information collection are requested 

with regard to any of the following: (a) 

Whether the proposed collection of 

information is necessary for the proper 

performance of AHRQ healthcare 

research and healthcare information 

dissemination functions, including 

whether the information will have 

practical utility; (b) the accuracy of 

AHRQ’s estimate of burden (including 

hours and costs) of the proposed 

collection(s) of information; (c) ways to 

enhance the quality, utility, and clarity 

of the information to be collected; and 

(d) ways to minimize the burden of the 

collection of information upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: January 17, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–1402 Filed 1–25–12; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: ‘‘Nursing 

Home Survey on Patient Safety Culture 

Comparative Database.’’ In accordance 

with the Paperwork Reduction Act, 44 

U.S.C. 3501–3521, AHRQ invites the 

public to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on November 2nd, 2011 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by February 27, 2012. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at 

OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Nursing Home Survey on Patient Safety 

Culture Comparative Database 

The Agency for Healthcare Research 

and Quality (AHRQ) requests that the 

Office of Management and Budget 

(OMB) approve, under the Paperwork 

Reduction Act of 1995, AHRQ’s 

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