Federal Register / Vol. 74, No. 61 / Wednesday, April 1, 2009 / Notices 14803 

Dated: March 23, 2009. 

[FR Doc. E9–7244 Filed 3–31–09; 8:45 am] 

BILLING CODE 6820–DH–P 

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 Organizational Responses to 

AHRQ’s Health Literacy Pharmacy 

Tools.’’ In accordance with the 

Paperwork Reduction Act of 1995, 44 

U.S.C. 3506(c)(2)(A), AHRQ invites the 

public to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on January 29th, 2009 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 May 1, 2009. 

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 

e-mail at doris.lefkowitz@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: Proposed 

Project: Assessing Organizational 

Responses to AHRQ’s Health Literacy 

Pharmacy Tools. 

According to the 2003 National 

Assessment of Adult Literacy, only 12 

percent of adults have proficient health 

literacy—the capacity to obtain, process, 

and understand basic health 

information and services needed to 

make appropriate health decisions. 

Limited health literacy often leads to 

medication errors. For example, one 

study found that a majority of adults 

with low health literacy did not 

understand instructions to ‘‘take 

medication on an empty stomach.’’ 

Overall, it is estimated that low health 

literacy costs the U.S. health care 

system $50 billion to $73 billion per 

year. Pharmacies can serve as an 

important source of medication 

information for people with limited 

health literacy, but relatively few 

pharmacies have implemented health 

literacy practices (Praska et al., 2005). 

Recognizing that pharmacies may 

need outside knowledge and assistance 

to improve their health literacy 

practices, AHRQ, through a previous 

task order, supported the creation of the 

following four health literacy tools for 

pharmacy settings, which have been 

validated in institutional pharmacy 

settings. 

1. Is Our Pharmacy Meeting Patients’ 

Needs? A Pharmacy Health Literacy 

Assessment Tool User’s Guide (Jacobson 

et al., 2007). 

2. Strategies to improve 

Communication between Staff and 

Patients: Training Program for Pharmacy 

Staff (Kripalini & Jacobson, 2007). 

3. How to Create a Pill Card (Jacobson 

et al., 2008). 

4. Telephone Reminders: A Tool to 

Help Refill Medications on Time 

(Jacobson et al., 2008). 

AHRQ now proposes to distribute 

these tools to a more diverse set of 

pharmacies and to conduct in-depth 

case studies to enhance our 

understanding about the conditions that 

may facilitate or impede the adoption of 

the tools in these settings. AHRQ would 

use insights gained to develop materials 

(promotional implementation guides) 

that could assist interested pharmacies 

in putting the tools into practice and 

anticipating and overcoming obstacles 

to doing so. 

The pharmacy health literacy tools 

will be disseminated through an AHRQ 

Web site, which will also provide 

technical assistance to pharmacies that 

wish to implement the tools. A 

description of the tools and site will be 

distributed to pharmacists through 

national pharmacy organizations’ trade 

publications and a direct mailing to 

chain pharmacy headquarters. We 

anticipate that we would be able to 

reach as many as 60,000 individual 

pharmacists across the country through 

these channels. 

This project is being conducted 

pursuant to AHRQ’s statutory authority 

to conduct and support research on 

health care and on systems for the 

delivery of such care, including 

activities with respect to: The quality, 

effectiveness, efficiency, 

appropriateness and value of health care 

services; quality measurement and 

improvement; and health care costs, 

productivity, organization, and market 

forces. 42 U.S.C. 299a(a)(1), (2), and (6). 

Method of Collection 

Case Studies 

Through its contractor, AHRQ 

proposes to conduct 7 in-depth case 

studies to assess pharmacies’ 

experiences with implementation of one 

or more of these four health literacy 

tools, using interviews, site visits, 

review of documents and a survey of 

pharmacy staff from case study 

pharmacies. In addition, AHRQ will 

conduct 2 more limited studies of 

pharmacies that were aware of the tools 

but chose not to implement them. 

A 1-day site visit will be conducted 

with each of the 7 sites that implement 

at least one of the tools. Each site visit 

will include a walk-through of the 

pharmacy site to see the physical layout, 

an interview with the key informant or 

contact person, and individual 

interviews with up to four additional 

pharmacy employees, who may include 

the pharmacy manager, staff 

pharmacists, pharmacy technicians, and 

pharmacy clerks. 

Therefore, up to 35 interviews will be 

completed across the 7 sites that 

implement one or more of the tools. In 

addition, up to 12 pharmacy staff at 

each of the 7 implementation sites will 

complete the tool’s Pharmacy Staff 

Survey contained in the Pharmacy 

Health Literacy Assessment Tool. 

For each of the two pharmacies which 

do not implement the tools, interviews 

will be conducted with up to 2 

informants per site. The content of this 

interview will be similar, but not 

identical, to the interviews with staff at 

the implementing sites. 

Web Site Visitors’ Survey 

For pharmacists and other visitors to 

the AHRQ Web site, we will conduct a 

voluntary survey regarding health 

literacy in general, and feedback 

regarding AHRQ’s health literacy tools. 

The Web site visitors’ survey will be 

available on-line. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondents’ time to participate in the 

case studies. The staff interview at the 

implementing sites will be completed 

with up to 5 total pharmacy staff 

members from each of the 7 pharmacies 

that implement at least one of the health 

literacy tools. Staff interviews at the two 

14804 Federal Register / Vol. 74, No. 61 / Wednesday, April 1, 2009 / Notices 

non-implementation sites will be 

completed with up to 2 individuals per 

pharmacy. The interviews are estimated 

to last 1 hour for each of the 5 staff 

interviews at the 7 implementing sites 

and 30 minutes for each of the 2 staff 

interviews at the 2 non-implementing 

sites. The pharmacy staff survey will be 

completed by up to 12 staff from the 7 

implementation pharmacies and is 

estimated to take approximately 20 

minutes. Lastly, we estimate that the 

Web site visitor’s survey will be 

completed by about 150 respondents 

and is estimated to take up to 12 

minutes to complete. The total burden 

hours for all data collections is 

estimated to be 95 hours. 

Exhibit 2 shows the estimated 

annualized cost burden for the 

respondents’ time to provide the 

requested data. The estimated total cost 

burden is $2,882. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name 

Number of 

sites/ 

respondents 

Number of responses per 

sites/ 

respondents 

Hours per 

response 

Total burden 

hours 

Staff interview—implementing sites ................................................................. 7 5 1 35 

Staff interview—non-implementing sites .......................................................... 2 2 30/60 2 

Pharmacy staff survey ..................................................................................... 7 12 20/60 28 

Web site visitors survey ................................................................................... 150 1 12/60 30 

Total .......................................................................................................... 166 ........................ ........................ 95 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name 

Number of 

sites/ 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

Staff interview—implementing sites ................................................................. 7 35 $30.33 $1,062 

Staff interview—non-implementing sites .......................................................... 2 2 30.33 61 

Pharmacy staff survey ..................................................................................... 7 28 30.33 849 

Web site visitors survey ................................................................................... 150 30 30.33 910 

Total .......................................................................................................... 166 95 ........................ 2,882 

*The average hourly wage rate of $30.33 was calculated based on the following mean hourly wage rates: Pharmacists—$47.58; pharmacy 

manager [medical & health services manager category]—$50.34; pharmacy technicians—$13.25; and pharmacy aides—$10.15. The mean hourly 

wage rates for these occupations were obtained from the Bureau of Labor & Statistics on ‘‘Occupational Employment and Wages, May 2007,’’ 

found at: http://www.bls.gov/OES/current/oes291051.htm. 

Estimated Annual Costs to the 

Government 

The total cost of this contract to the 

government is $400,000. The project 

extends over three fiscal years. Exhibit 

3 shows a breakdown of the total cost 

as well as the annualized cost. 

EXHIBIT 3—ESTIMATED COST

Cost component Total cost Annualized 

cost 

Project Development ............................................................................................................................................... $54,822 $18,274 

Data Collection Activities ......................................................................................................................................... 111,509 37,170 

Data Processing and Analysis ................................................................................................................................. 129,089 43,030 

Publication of Results .............................................................................................................................................. 63,736 21,245 

Project Management ................................................................................................................................................ 40,845 13,615 

Total .................................................................................................................................................................. 400,000 133,333 

Request for Comments 

In accordance with the above cited 

legislation, comments on the AHRQ 

information collection proposal are 

requested with regard to any of the 

following: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of functions 

of AHRQ, 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 of information; 

(c) ways to enhance the quality, utility, 

and clarity on the information to be 

collected; and (d) ways to minimize the 

burden of the collection of information 

on 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 request for OMB 

approval of the proposed information 

collection. All comments will become a 

matter of public record. 

Dated: March 20, 2009. 

Carolyn M. Clancy, 

Director. 

[FR Doc. E9–6957 Filed 3–31–09; 8:45 am] 

BILLING CODE 4160–90–M