[Federal Register Volume 72, Number 146 (Tuesday, July 31, 2007)]
[Notices]
[Pages 41757-41758]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-14703]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-07-07BE]


Proposed Data Collections Submitted for Public Comment and 
Recommendations

    In compliance with the requirement of Section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995 for opportunity for public comment on 
proposed data collection projects, the Centers for Disease Control and 
Prevention (CDC) will publish periodic summaries of proposed projects. 
To request more information on the proposed projects or to obtain a 
copy of the data collection plans and instruments, call 404-639-5960 
and send comments to Maryam I. Daneshvar, CDC Acting Reports Clearance 
Officer, 1600 Clifton Road, MS-D74, Atlanta, GA 30333 or send an e-mail 
to [email protected].
    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed collection 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 on respondents, 
including through the use of automated collection techniques or other 
forms of information technology. Written comments should be received 
within 60 days of this notice.

Proposed Project

    Research to Reduce Time to Treatment for Heart Attack/Myocardial 
Infraction for Rural American Indians/Alaska Natives (AI/AN)--NEW--
National Center for Chronic Disease Prevention and Health Promotion 
(NCCDPHP), Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Every year, approximately 1.1 million Americans have a first or 
recurrent heart attack/myocardial infarction (MI) and about one third 
of these will be fatal. Early recognition of MI by both the victim and 
bystanders followed by prompt cardiac emergency and advanced care has a 
direct effect on patient outcomes (heart damage, morbidity and 
mortality): the shorter the delay to treatment, the better the 
outcomes. Results of a recent Behavioral Risk Factor Survey (BRFSS) 
survey showed that public recognition of major MI symptoms and the need 
for immediate action by calling 9-1-1 was poor and that there is a need 
for increased public health efforts. Patient delay accounts for most of 
the lag in treatment.
    Data from the National MI Registry show that the greatest disparity 
for delay in treatment exists among the racial and ethnic groups of 
American Indian/Alaskan Native group. The NATIVE study shows that rural 
American Indians presenting with acute MI have marked delays in time to 
treatment (12% of patients waited between 12-24 hours and 23% waited 
more than 24 hours to present) thus, limiting treatment options; the 
primary cause of the delay was due to patient misunderstandings about 
the symptoms of MI.
    The project will contribute to our understanding of AI/AN 
populations and their perceptions of and misconceptions about MI and 
the need for immediate treatment. Information gained from this project 
will provide the details needed to tailor message(s) for this 
population. The agency will develop culturally-tailored messages for 
native populations that will contribute to the existing National Heart 
Attack program (NHLBI) ``Act in Time'' messages.
    There will be a minimum of 84 key informant interviews and 16 
persons in the two focus groups. The key informants will consist of 
healthcare providers, community leader, and persons who have had an MI. 
Key informants will be identified for interviews through a clustered, 
multistate snowball sampling technique. In recognition of the tribal 
diversity; study participants will represent three AI/AN regions of the 
U.S.: Great Plains identified by the Aberdeen Area Indian Health 
Service area, the South West distinct to the Phoenix, Albuquerque and 
Tucson areas and Alaskan Natives. Interview participants will have 
established relationships with tribes or

[[Page 41758]]

are members of tribes, and have a good sense of cultural health 
beliefs.
    The healthcare provider group will consist of nomination by the 
Indian Health Service Chief Medical Officer (IHSCMO), who will nominate 
3 MD/NP's or PA's and 3 nurses in each region. The participating 
emergency care providers will each be asked to nominate 2 providers 
from a cardiology clinic (cardiologists or cardiac nurses) and/or a 
pre-hospital (EMT/Paramedic) provider. The 6 original from each region 
will subtotal to 18 emergency care providers plus the 2 individuals 
they each nominate will subtotal to 36 from each region, a total of 54 
pre-hospital and cardiology providers (medical providers) key informant 
interviews covering all three regions.
    The community key informants will consist of 3 tribal health 
directors who will nominate 3 community key informants from each 
region, who will then each nominate 2 additional community members to 
be interviewed for a sample of 30 community key informants.
    The individual key informant interviews of the group of patients 
who have had an MI or have a high risk of MI, nominated by the 
physicians, nurses and community members will be asked to nominate 
individuals whom they know have had or are at risk for a heart attack. 
The medical providers and community members asked to participate in the 
key informant interviews will equal a minimum of approximately 27 
health providers, 15 community members or 42 key informant interview, 
each contacts 2 individuals, a minimum of 168 respondents to the 
survey.
    After the key informant interviews have been completed and analyzed 
there will be two community focus groups each comprised of 8 to 10 
participants from all three regions held. The first involving patients 
who have had an MI and the second focus group will involve community 
members at risk for MIs.
    There are no costs to the respondent except their time to 
participate in the survey.

                                        Estimated Annualized Burden Hours
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                                                                                      Average
                                                     Number of        No. of        burden per     Total burden
                   Respondents                      respondents    responses per   response (in     (in hours)
                                                                    respondent         hrs.)
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Healthcare providers............................              54               1               1              54
Community leaders...............................              30               1               1              30
Community members interviews....................             168               1               1             168
(2) Community member focus group retreats.......              20               1               8             160
    Total.......................................  ..............  ..............  ..............             412
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    Dated: July 25, 2007.
Maryam I. Daneshvar,
Acting Reports Clearance Officer, Centers for Disease Control and 
Prevention.
 [FR Doc. E7-14703 Filed 7-30-07; 8:45 am]
BILLING CODE 4163-18-P