[Federal Register Volume 83, Number 170 (Friday, August 31, 2018)]
[Notices]
[Pages 44628-44630]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-19012]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-18-0743]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Monitoring Breastfeeding-Related Maternity 
Care--U.S. hospitals to the Office of Management and Budget (OMB) for 
review and approval. CDC previously published a ``Proposed Data 
Collection Submitted for Public Comment and Recommendations'' notice on 
November 22, 2017, to obtain comments from the public and affected 
agencies. CDC received 12 comments related to the previous notice. This 
notice serves to allow an additional 30 days for public and affected 
agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to <a href="/cdn-cgi/l/email-protection#157a7877557671763b727a63"><span class="__cf_email__" data-cfemail="37585a557754535419505841">[email protected]</span></a>. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202)

[[Page 44629]]

395-5806. Provide written comments within 30 days of notice 
publication.

Proposed Project

    Monitoring Breastfeeding-Related Maternity Care--U.S. Hospitals 
(OMB Control No. 0920-0743, Exp. 9/30/2016)--Reinstatement with 
Change--Division of Nutrition, Physical Activity, and Obesity, National 
Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 
Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Substantial evidence demonstrates the social, economic, and health 
benefits of breastfeeding for both the mother and infant as well as for 
society in general. Breastfeeding mothers have lower risks of breast 
and ovarian cancers and type 2 diabetes, and breastfeeding better 
protects infants against infections, chronic diseases like diabetes and 
obesity, and even childhood leukemia and sudden infant death syndrome 
(SIDS). However, the groups that are at higher risk for diabetes, 
obesity, and poor health overall persistently have the lowest 
breastfeeding rates.
    Health professionals recommend at least 12 months of breastfeeding, 
and Healthy People 2020 establishes specific national breastfeeding 
goals. In addition to increasing overall rates, a significant public 
health priority in the United States is to reduce variation in 
breastfeeding rates across population subgroups. Although CDC 
surveillance data indicate that breastfeeding initiation rates in the 
United States are climbing, rates for duration and exclusivity continue 
to lag, and significant disparities persist between African American 
and white women in breastfeeding rates.
    The health care system is one of the most important and effective 
settings to improve breastfeeding. Recognition of the hospital stay as 
a crucial influence in later breastfeeding outcomes led to the addition 
of two objectives in Healthy People 2020 to allow national monitoring 
of improvements in support for breastfeeding during this time. In 2007, 
CDC conducted the first national survey of Maternity Practices in 
Infant Nutrition and Care (known as the mPINC Survey) in health care 
facilities (hospitals and free-standing childbirth centers). This 
survey was designed to provide baseline information and to be repeated 
every two years. The survey was conducted again in 2009, 2011, 2013, 
and 2015. The survey inquired about patient education and support for 
breastfeeding throughout the maternity stay as well as staff training 
and maternity care policies.
    Prior to the fielding of the 2009 iteration, CDC was requested to 
provide a report to OMB on the results of the 2007 collection. In this 
report, CDC provided survey results by geographic and demographic 
characteristics and a summary of activities that resulted from the 
survey. A summary of mPINC findings was also the anchor of all 
activities related to the CDC August 2011 Vital Signs activity, marking 
the first time that CDC highlighted improving hospital maternity 
practices as the CDC-wide public health priority. A summary of mPINC 
findings provided the basis of the CDC October 2015 Vital Signs report, 
which updated the 2011 Vital Signs report and concluded that although 
maternity care policies and practices supportive of breastfeeding are 
improving nationally; more work is needed to ensure all women receive 
optimal breastfeeding support during the birth hospitalization.
    The planned methodology for the 2018 and 2020 national survey of 
Maternity Practices in Infant Nutrition and Care (mPINC) will closely 
match that of the previously administered mPINC surveys in 2007, 2009, 
2011, 2013, and 2015. Changes described in this Reinstatement with 
change include: (1) Deployment of 2018 and 2020 Surveys; (2) data 
collection via web-survey only (no paper surveys); (3) surveying 
hospitals only (not birth centers); (4) requesting contact information 
for two individuals per facility (previously only one); (5) an updated 
American Hospital Association (AHA) database will be acquired to 
identify hospitals not currently on the list for recruitment in the 
2018 survey. This process will not occur for the 2020 survey, but 
additional hospitals identified from the new database for 2018 will be 
included in the 2020 survey; (6) 2018 and 2020 survey content has been 
updated.
    A major strength of the mPINC survey is its structure as an ongoing 
national census, which does not employ sampling methods. Facilities are 
identified by using the American Hospital Association (AHA) Annual 
Survey of Hospitals. Facilities that will be invited to participate in 
the survey include hospitals that participated in previous iterations 
and those that were invited but did not participate in the previous 
iterations, as well as those that have become eligible since the most 
recent mPINC survey. All hospitals with >=1 registered maternity bed 
will be screened via a brief phone call to assess their eligibility, 
identify additional satellite locations, and identify the appropriate 
point of contact. The high response rates to the previous iterations of 
the mPINC survey (82-83% in 2007, 2009, 2011, 2013, and 2015) indicate 
that the methodology is appropriate and also reflects high interest 
among the study population.
    As with the initial surveys, a major goal of the 2018 and 2020 
follow-up surveys is to be fully responsive to hospitals' needs for 
information and technical assistance. CDC will provide direct feedback 
to hospital respondents in a customized benchmark report of their 
results. CDC will use information from the mPINC surveys to identify, 
document, and share information related to incremental changes in 
practices and care processes over time at the hospital, state, and 
national levels. Data are also used by researchers to better understand 
the relationships between hospital characteristics, maternity-care 
practices, state level factors, and breastfeeding initiation and 
continuation rates. Participation in the survey is voluntary, and 
responses may be submitted through a Web-based system. The total 
estimated annual Burden Hours are 855. There are no costs to 
respondents other than their time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondents                   Form name            Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
Maternity Hospital....................  Screening Call Script              1,952               1            1/60
                                         Part A.
Maternity Hospital....................  Screening Call Script              1,672               1            4/60
                                         Part B.
Maternity Hospital....................  mPINC Facility Survey...           1,421               1           30/60
----------------------------------------------------------------------------------------------------------------



[[Page 44630]]

Jeffrey M. Zirger,
Acting Chief, Information Collection Review Office, Office of 
Scientific Integrity, Office of the Associate Director for Science, 
Office of the Director, Centers for Disease Control and Prevention.
[FR Doc. 2018-19012 Filed 8-30-18; 8:45 am]
 BILLING CODE 4163-18-P


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