[Federal Register Volume 74, Number 61 (Wednesday, April 1, 2009)]
[Notices]
[Pages 14803-14804]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-6957]
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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.
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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
e-mail at [email protected] (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
[email protected].
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
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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
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Number of
Number of responses per Hours per Total burden
Form name sites/ sites/ response hours
respondents respondents
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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
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Total....................................... 166 .............. .............. 95
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Exhibit 2--Estimated Annualized Cost Burden
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Number of
Form name sites/ Total burden Average hourly Total cost
respondents hours wage rate* burden
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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
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Total....................................... 166 95 .............. 2,882
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*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
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Annualized
Cost component Total cost cost
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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
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Total............................... 400,000 133,333
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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]
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