[Federal Register Volume 70, Number 167 (Tuesday, August 30, 2005)]
[Notices]
[Pages 51358-51360]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-17178]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    Periodically, the Substance Abuse and Mental Health Services 
Administration (SAMHSA) will publish a summary of information 
collection requests under OMB review, in compliance with the Paperwork 
Reduction Act (44 U.S.C. Chapter 35). To request a copy of these 
documents, call the SAMHSA Reports Clearance Officer on (240) 276-1243.

Project: National Outcome Measures for Substance Abuse Prevention (OMB 
No. 0930-0230)--Revision

    Given SAMHSA's emphasis on reducing burden and limiting required 
measures, CSAP has proposed a greatly reduced OMB clearance package 
that would include a small set of required measures. Seven optional 
measures are also included under this proposed approach and are 
indicated by an asterisk (*). CSAP would like to characterize this set 
of measures as the NOMs for prevention. Honoring our agreement with the 
States, these optional and required NOMs may be modified based upon 
further dialogue with the States as NOMs implementation proceeds. In 
addition to requesting approval to collect data using four current GPRA 
measures (30 day use, age of first use, disapproval, perceived risk), 
CSAP has added the following:

Abstinence

    Binge Drinking.\*\ Binge drinking is distinct from past 30 day use 
in that it involves dangerous amounts of alcohol consumption on any 
given occasion. Binge drinking is a public health concern because it is 
widespread among young adults and adolescents and contributes directly 
to injuries and fatalities. Evidence-based prevention strategies, 
programs, and policies exist to reduce binge drinking, with several 
programs focusing on binge drinking on college campuses. SAMHSA 
currently supports a nation-wide underage drinking initiative, which 
includes a focus on reducing binge drinking among our youth. The NSDUH, 
Youth Risk Behavior Survey (YRBS), Behavioral Risk Factor Surveillance 
System (BRFSS) are nearly identical and ask the number of times during 
the past 30 days that the respondent had five or more drinks on a 
single occasion or within a couple of hours. The MTF and College 
Alcohol Study ask the same question, but use the past two weeks as the 
reference period. The College Alcohol Survey also asks how many times 
the respondent had four drinks. Given the similarity of these measures, 
CSAP recommends the NSDUH measure for consistency with our other NOMs.
    Perceived Availability.\*\ Perceived availability of alcohol and 
illicit drugs is associated with alcohol and illicit drug consumption. 
Perceived availability is distinct from other NOM correlates of 
substance use (e.g., perceived risk) because it provides insight into 
respondents' beliefs regarding environmental conditions that may affect 
substance use. Efforts to reduce availability (perceived or real) have 
been shown to reduce consumption and consequences of alcohol and 
illicit drug use. CSAP recommends including perceived availability 
because of its strong association with alcohol and illicit drug use 
correlation with alcohol use = .44; marijuana use = .33) and prevalence 
in prevention programming. CSAP recommends the NSDUH measure on 
perceived availability of illicit drugs because data are collected 
annually and this would be consistent with our other NOM measures 
(.27-.45 correlation w/ use).

Criminal Involvement

    Antisocial Behavior\*\. Antisocial/delinquent behavior is 
predictive of involvement in the criminal justice system and is 
correlated with substance use. Therefore, it is relevant to measures 
this construct within this domain, particularly among adolescents who 
may not yet be involved in the criminal justice system. Antisocial/
delinquent behavior is distinct from other NOM constructs (e.g., drug-
related crime) in that it addresses a broad set of problem behaviors, 
rather than a more narrow set of behaviors that result in arrest or 
adjudication. CSAP recommends including antisocial and delinquent 
behavior because these behaviors are predictive of involvement in the 
criminal justice system and are correlated with substance use (alcohol 
= 23; marijuana = .29). Many evidence-based substance abuse prevention 
programs target antisocial/delinquent violent behaviors (.23-.375 
correlation w/use), especially those for selective and indicated 
populations. Epidemiologic measures from state and community level 
sources (AOD related car crashes, police reports on drug related 
incidents) are not appropriate performance measures for those more 
targeted, direct service types of programs. This is why we are 
recommending the survey measures from the NSDUH.
    Alcohol and drug related arrests.\*\ According to the most recent 
NSDUH survey results ``* * * youths in 2003 were more likely to have 
used an illicit drug in the past month if they carried a handgun (32.5 
vs. 10.4 percent), sold illegal drugs (67.0 vs. 9.1 percent), or stolen 
or tried to steal something worth $50 or more (39.1 vs. 9.9 percent)''. 
Clearly, the relationship between criminal conduct while using 
substances is an accepted fact. For programs that are targeting risk 
factors that underlie both substance use and illegal behavior, this is 
an extremely pertinent performance measure. This NSDUH survey measure 
is particularly important for programs that are selective or indicated, 
because the other community level (epidemiological) NOM data will 
likely not reflect their performance.

Social Support/Social Connectedness (Currently on the NOM Web site as 
Under Development)

    Community Involvement.\*\ Community involvement is associated with 
social support and social connectedness and, therefore, is a relevant 
construct to measure within this domain. For example, increased 
community involvement was associated with improved family interactions 
and parent attitude (Substance Abuse Prevention Evaluation Outcomes 
Fiscal Year 2004, New Mexico Department of Health Publication, October 
2004)
    CSAP recommends including community involvement because of this 
relationship. There was discussion about the construct itself and what 
it means to be involved in one's community. There are a number of ways 
to measure community involvement, such as participation in many 
different types of activities, or pursuing a few activities with 
commitment. In order to keep the data source consistent and be assured 
of obtaining national and state level data, CSAP recommends the NSDUH 
prevention measures for assessing actual participation in community 
activities.
    Collective Efficacy \*\. Collective efficacy refers to the extent 
to which community members feel that they monitor their neighborhoods, 
look after each other, and share common values. Perhaps, because 
measurement in the area of collective efficacy is fairly new, it was 
difficult to find data to support or refute the idea that it is 
associated with substance use. However, it is clearly reflective of the 
purpose of the Drug Free Communities program, and

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CSAP/SAMHSA's philosophical and practical focus regarding coalition 
building and other empowerment infrastructure activities. Because of 
its accessibility in the public domain, CSAP recommends the NSDUH 
measure of collective efficacy as a prevention outcome measure. It has 
a high reliability (greater than .80) as a cohesive measure.
    Family Communication<SUP>*</SUP>. Positive parent-child 
communication is an objective of family-based prevention interventions. 
The family is emphasized by this administration, and is ``the anti-
drug'' in ONDCP campaigns. Research has shown that family factors play 
an important role in the etiology of substance abuse, as well as the 
positive development of children and youth (Spoth, Kavanagh, & Dishion, 
2002). In addition, family- and parent-centered prevention 
interventions have been developed, evaluated, and disseminated in ever 
increasing numbers during the last decade (e.g., Bauman et al., 2001; 
Dishion & Kavanagh, 2000; Spoth, Redmond, & Shin, 2001). CSAP 
recommends the NSDUH items regarding family communications specifically 
about drug abuse. The NSDUH includes one item for children (During the 
past 12 months, have you talked with at least one of your parents about 
the dangers of tobacco, alcohol, or drug use?), and two for parents 
(During the past 12 months, how many times have you talked with your 
child about the dangers or problems associated with the use of tobacco, 
alcohol, or other drugs? Think about the most serious and thorough 
discussion about drugs you had with your child during the past 12 
months. About how long did this discussion last?). These one- and two-
item measures have merit for prevention because they ask specifically 
about conversations regarding ATOD and they are collected annually. 
(.20-.27 correlation w/use)
    CSAP believes that these measures are necessary to include as NOMs 
based on its long history working with states, communities and 
prevention providers, and on input from its Data Coordinating Center 
and outside expert panels who made recommendations based on a review of 
existing measures using standard criteria. Additionally, we believe 
that these measures can be collected at the national, state, substate 
and/or program level as appropriate, providing the consistency of 
measurement towards which we strive. Additional NOMs epidemiologic 
measures t are already collected by other agencies and no burden will 
be posed to SAMHSA/CSAP grantees. The measures will be used as follows:
    National/State: Outcome trend measures to identify need and monitor 
global effectiveness at the population level, for the purpose of 
informing federal resource allocation decisions.
    Community: Outcome trend measures to (1) determine need and target 
resources to communities at greatest risk, (2) track performance of 
universal programs and environmental strategies. The data will inform 
allocation of community resources.
    Program: Outcome pre/post measures to assess program performance of 
direct service programs at the individual program participant level.

----------------------------------------------------------------------------------------------------------------
               Domain                            NOM                                Data source
----------------------------------------------------------------------------------------------------------------
Abstinence.........................  30 day substance use:        NSDUH.
                                      nonuse/reduction in use
                                      (1); Age of first use;
                                      Perception of disapproval/
                                      attitude (1); Perceived
                                      risk/harm of use (1);
                                      Binge drinking*; Perceived
                                      availability*.
Employment/Education...............  Workplace AOD use and        NSDUH.
                                      perception of workplace
                                      policy (adult);
                                     ATOD-related suspensions     DofED RECORDS.
                                      and expulsions (youth).
Crime and Criminal Justice.........  Alcohol related car crashes  FARS.
                                      and injuries.
                                     Drug related crime.........  UCR.
                                     Alcohol and drug related     NSDUH.
                                      arrests*; Antisocial
                                      behavior*.
Stability in Housing...............  N/A
Access/Service Capacity              <greek-i> of persons served  MDS.
                                      by age, gender, race,
                                      ethnicity.
Retention..........................  Total <greek-i> evidence     MDS.
                                      based programs and
                                      strategies.
Social Support/Social Connectedness  Collective efficacy*;        NSDUH.
                                      Community Involvement*;
                                      Family communication-drug
                                      use*.
Cost Effectiveness.................  Increase services provided   Template (under development).
                                      within cost bands (within
                                      universal, selective and
                                      indicated programs).\1\
Use of Evidence Based Practices....  Total <greek-i> of evidence  MDS.
                                      based programs and
                                      strategies.\1\
----------------------------------------------------------------------------------------------------------------
\1\ PART measure.
Notes.--(Other Part measures for CSAP): past year use: BG.
<greek-i> practices reviewed and approved NREP: PRNS.
Percent states satisfied w/TA: BG.


----------------------------------------------------------------------------------------------------------------
                                                     Number of      Responses/        Hours/
               SAMHSA/CSAP program                   grantees         grantee        response       Total hours
----------------------------------------------------------------------------------------------------------------
                      FY05
Knowledge Development:
    Club drugs/Methamphetamine..................              22               2               3             132
    Fetal Alcohol...............................               6               2               3              36
    Workplace...................................              13               2               3              78
Targeted Capacity Enhancement:
    HIV/Targeted Capacity.......................              45               2               3             270
    SPF SIG.....................................              21               2               3             126
                                                 -----------------
        FY05 Total..............................             106  ..............  ..............             642
                                                 =================
                      FY06
Knowledge Development:
    Club Drugs/Methamphetamine..................              22               2               3             132

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    Fetal Alcohol...............................               6               2               3              36
    Workplace...................................              13               2               3              78
Targeted Capacity Enhancement:
    HIV/Targeted Capacity.......................              45               2               3             270
    SPF SIG.....................................              40               2               3             240
                                                 -----------------
        FY06 Total..............................             126  ..............  ..............             756
                                                 =================
                      FY07
Knowledge Development:
    Club Drugs/Methamphetamine..................              22               2               3             132
    Fetal Alcohol...............................               6               2               3              36
    Workplace...................................              13               2               3              78
Targeted Capacity Enhancement:
    HIV/Targeted Capacity.......................              45               2               3             270
    SPF SIG.....................................              50               2               3             300
                                                 -----------------
        FY07 Total..............................             136  ..............  ..............             816
                                                 =================
        3-Year Annual Average...................             123  ..............  ..............             736
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    Written comments and recommendations concerning the proposed 
information collection should be sent by September 29, 2005 to: SAMHSA 
Desk Officer, Human Resources and Housing Branch, Office of Management 
and Budget, New Executive Office Building, Room 10235, Washington, DC. 
20503; due to potential delays in OMB's receipt and processing of mail 
sent through the U.S. Postal Service, respondents are encouraged to 
submit comments by fax to: 202-395-6974.

    Dated: August 23, 2005.
Anna Marsh,
Executive Officer, SAMHSA.
[FR Doc. 05-17178 Filed 8-29-05; 8:45 am]
BILLING CODE 4162-20-P