[Federal Register Volume 76, Number 165 (Thursday, August 25, 2011)]
[Notices]
[Pages 53138-53141]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-21713]
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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 Child Traumatic Stress Initiative (NCTSI)
Evaluation--(OMB No. 0930-0276)--Revision
The Substance Abuse and Mental Health Services Administration's
(SAMHSA), Center for Mental Health Services (CMHS), will conduct the
National Child Traumatic Stress Initiative (NCTSI) Evaluation. This
evaluation serves multiple practical purposes: (1) To collect and
analyze descriptive, outcome, and service experience information about
the children and families served by the NCTSI centers; (2) to assess
the NCTSI's impact on access to high-quality, trauma-informed care; (3)
to evaluate NCTSI centers' training and consultation activity designed
to promote evidence-based, trauma-informed services and the impact of
such activity on child-serving systems; and (4) to assess the
sustainability of the grant-funded activities to improve access to and
quality of care for trauma-exposed children and their families beyond
the grant period.
Data will be collected from caregivers and youth served by NCTSI
centers, NCTSI and non-NCTSI administrators, NCTSI trainers, service
providers trained by NCTSI centers and other training participants,
administrators of mental health and non-mental health professionals
from state and national child-serving organizations, and administrators
of affiliate centers. Data collection will take place in all Community
Treatment and Services Programs (CTS) and Treatment and Service
Adaptation Centers (TSA) active during the three-year approval period.
Currently, there are 45 CTS centers and 17 TSA centers active (i.e., 62
active centers). After the first year, in September 2011, the 15
grantees funded in 2007 will reach the end of their data collection. At
that point, additional centers may be funded or funded again. Because
of this variability, the estimate of 62 centers is used to calculate
burden.
The NCTSI Evaluation is composed of four distinct study components,
each of which involves data collection, which are described below.
Descriptive and Clinical Outcomes
In order to describe the children served, their trauma histories
and their clinical and functional outcomes, nine instruments will be
used to collect data from children and adolescents who are receiving
services in the NCTSI, and from caregivers of all children who are
receiving NCTSI services. Data will be collected when the child/youth
enters services and during subsequent follow-up sessions at three-month
intervals over the course of one year. This study relies upon the use
of data already being collected as a part of the Core Data Set, and
includes the following instruments:
The Core Clinical Characteristics Form, which collects
demographic, psychosocial and clinical information about the child
being served including information about the child's domestic
environment and insurance status, indicators of the severity of the
child's problems, behaviors and symptoms, and use of non-Network
services;
The Trauma Information/Detail Form, which collects
information on the history of trauma(s) experienced by the child served
by the NCTSI center including the type of trauma experienced, the age
at which the trauma was experienced, type of exposure, whether or not
the trauma is chronic, and the setting and
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perpetrator(s) associated with the traumatic experience;
The Child Behavior Checklist (CBCL) 1.5-5 and 6-18, which
measure symptoms in such domains such as emotionally reactive, anxious/
depressed, somatic complaints, withdrawn, attention problems,
aggressive behavior, sleep problems, rule-breaking behavior, social
problems, thought problems, and withdrawn/depressed;
The UCLA PTSD Short Form, which screens for exposure to
traumatic events and for all DSM-IV PTSD symptoms in children who
report traumatic stress experiences; and the
The Trauma Symptoms Checklist for Children, which
evaluates acute and chronic posttraumatic stress symptoms in children's
responses to unspecified traumatic events across several symptom
domains.
The Trauma Symptoms Checklist for Young Children (TSCYC),
which is a 90-item caretaker-report instrument developed for the
assessment of trauma-related symptoms in children ages 3 to 12.
The Parenting Stress Index Short Form (PSI-SF), which
yields a total stress score from three scales: Parental distress,
parent-child dysfunctional interaction, and difficult child. The PSI-SF
was developed from factor analysis of the PSI-Full-Length Version.
The Children's Depression Inventory-2 Short (CDI-2S),
which is a comprehensive multi-rater assessment of depressive symptoms
in youth aged 7 to 17 years. Depressive symptomatology is quantified by
the CDI 2 based on reports from children/adolescents, teachers and
parents.
The Global Appraisal of Individual Needs Modified Shore
Screener (GAIN-MSS), which is designed primarily as a screener in
general populations, ages 12 and older, to quickly and accurately
identify clients who have 1 or more behavioral health disorders (e.g.,
internalizing or externalizing psychiatric disorders, substance use
disorders, or crime/violence problems).
Approximately 6,000 youth and 9,700 caregivers will participate in
the descriptive and clinical outcomes study over the clearance period.
Access to High Quality, Trauma-Informed Services
The NCTSI mission is to expand access to high quality, trauma-
informed services for trauma-exposed children and adolescents and their
families nationwide. This component of the evaluation is designed to
assess NCTSI program progress in achieving this mission by collecting
and analyzing data from a variety of sources addressing the question of
whether access to high quality, trauma-informed services has improved
and for which demographic groups. Instruments used as a part of this
study component include:
Evidence-based Practice (EBP) and Trauma-informed Systems
Change Survey (ETSC), which assesses the extent to which NCTSI training
and other dissemination activities have enhanced the knowledge base and
use of trauma-informed services (TIS) within child-serving agencies,
centers and organizations that are not a part of the NCTSI but rather
have received training from the NCTSI as well as to assess the extent
to which such services are evidence-based. The survey branches into two
versions adapted for project directors/administrators and human service
providers (e.g., mental health providers, child welfare case workers,
teachers, primary care health care providers and others), allowing for
questions tailored to the professional orientation and activities of
each group. The ETSC survey will be used to assess the extent to which
NCTSI training and dissemination activities have improved access to
high quality, trauma-informed services for trauma-exposed children and
their families that are served through such child-serving systems.
The National Reach Survey, which assesses the extent to
which the NCTSI has impacted the knowledge and awareness, policies,
planning, programs, and practices related to trauma-informed care among
state and national child-serving organizations external to the NCTSI
centers.
The Online Performance Monitoring Report (OPMR), which is
primarily a mechanism for SAMHSA to monitor centers' progress towards
achieving stated goals and a fulfillment of SAMHSA requirements for
accountability and performance monitoring. In addition, this form will
also serve as an important data source informing several components of
the NCTSI evaluation.
Approximately 496 service providers and 186 administrators from
NCTSI centers and organizations or agencies trained by NCTSI centers
will participate in the ETSC survey. Approximately 4,000 individuals
will be participating in the National Reach Survey, while approximately
62 individuals will participate in the OPMR.
Training, Evidence-Based Practices (EBPs), and Family/Consumer
Partnerships
A major goal of the NCTSI is to enhance the capacity of
administrators and service providers from agencies, centers and
organizations associated with child-serving systems (including mental
health, child welfare, juvenile justice, education and primary care) to
use trauma-informed services (TIS) with trauma-exposed children and
their families. NCTSI centers promote the use of TIS within child-
serving systems to increase public awareness and knowledge about trauma
exposure, trauma impact, and the range of trauma-informed assessments
and services that are available. For this component, the ETSC Survey
will be used to assess whether agencies, schools, and organizations
that are a part of child-serving systems trained by the NCTSI have
become more evidence-based and trauma-informed. Two additional forms
will be used including:
The Training Summary Form (TSF), which will be completed
by trainers and will collect information on the number of participants
trained, the type of training (including the trauma types addressed in
the training), and the topics emphasized in the training.
The Training Sign-In Sheet (TSIS), which will be completed
by this participants of NCTSI-sponsored trainings. Participants will
provide their names; agency, organization or center for which they
work; their roles; and contact information including an email
addresses. In addition, they will be asked to indicate whether the
evaluation may contact them for participation.
Approximately 124 trainers will complete and submit the TSF, while
approximately 12,400 trainees will complete the TSIS.
Sustainability
Assessing the sustainability of the progress made by the NCTSI and
its partners is a key evaluation priority identified by stakeholders
advising on the redesign of the NCTSI Evaluation. Therefore, while this
issue was not addressed as part of the previous evaluation design, it
has been included as a new area of importance for future NCTSI
evaluation. This component of the evaluation focuses on understanding
the degree to which NCTSI grant activities continue after funding has
ended and the factors associated with the continuation of--or lapse
in--grant activities such as the implementation of evidence-based
practices or approaches to strengthen trauma-informed service
provision. This component collects
[[Page 53140]]
sustainability data as part of the OPMR in the case of funded centers
and, in the case of affiliate centers (centers that no longer receive
SAMHSA funding but have continued involvement with the NCTSI and are
defined by SAMHSA as affiliates), the following survey will be
implemented:
Sustainability Survey for Affiliate Centers, which
assesses sustainability of NCTSI grant activities by collecting data on
domains including grant history, funding sources and fiscal strategies,
program mission, infrastructure, service delivery and continuation of
practices and programs. Approximately 45 administrators of affiliate
centers are expected to participate in this survey.
The revision to the currently approved information collection
activities includes the extension of NCTSI Evaluation information
collection activities for an additional three years. This revision also
addresses the following programmatic changes:
The number of centers for which burden was calculated is
62, which represents the number of currently active grantees (the
number of centers at the time of the previous submission was 44).
As a result of efforts to address updated evaluation
priorities, reduce redundancy and consolidate multiple data collection
efforts focused on national monitoring and evaluating of the NCTSI
program, the request discontinues ten surveys, forms or interviews that
are currently OMB-approved.
In place of the ten surveys, forms or interviews that are
currently OMB-approved that are being discontinued, and as part of the
redesigned evaluation, three new data collection efforts will be
implemented, including:
[cir] Online Performance Monitoring Report Form (OPMR)
[cir] Evidence-based Practice and Trauma-informed System Change
Survey (ETSC)
[cir] Sustainability Survey for affiliate centers
This request also enhances the existing Core Data Set by
revising the Core Clinical Characteristics Forms and adding new
instruments to address existing gaps in knowledge including:
[cir] Trauma Symptom Checklist for Young Children (TSCYC)
[cir] Parenting Stress Index Short Form (PSI-SF)
[cir] Children's Depression Inventory-2 Short (CDI-2S)
[cir] Global Appraisal of Needs Modified Short Screener (GAIN-MSS)
A Training Sign-in Sheet (TSIS) has been developed for use
at each training event sponsored by NCTSI centers. The purpose of the
form is to collect brief information about NCTSI training participants.
The average annual respondent burden is estimated below.
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Average number 3-year average
Instrument Number of of responses Hours per Total burden of annual
respondents per respondent response hours burden hours
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Caregivers Served by NCTSI Centers
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Child Behavior Checklist 1.5-5/6- \1\ 9,729 \2\ 4 0.33 12,842 4,281
18 (CBCL 1.5-5/6-18)...........
Trauma Information/Detail Form.. 9,729 4 0.22 8,562 2,854
Core Clinical Characteristics 9,729 4 0.5 19,458 6,486
Form...........................
UCLA-PTSD Short Form (UCLA-PTSD) \3\ 7,394 4 0.17 5,028 1,676
Trauma Symptoms Checklist for \4\ 2,724 4 0.33 3,596 1,199
Young Children (TSCYC).........
Parenting Stress Index Short \5\ 2,919 4 0.08 934 311
Form (PSI-SF)..................
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Youth Served by NCTSI Centers Centers
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Trauma Symptoms Checklist for \6\ 6,129 4 0.33 8,090 2,697
Children-Abbreviated (TSCC-A)..
Children's Depression Inventory- \7\ 2,140 4 0.08 685 228
2 Short (CDI-2S)...............
Global Appraisal of Individual \8\ 3,989 4 0.08 1,276 425
Needs Modified Shore Screener
(GAIN-MSS).....................
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Funded NCTSI Center Project Directors of Other Administrators
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Online Performance Monitoring 62 12 0.60 446 149
Report (OPMR)..................
Sustainability Survey for 62 3 0.28 52 17
Currently--Funded Centers......
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NCTSI and Non-NCTSI Administrators
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Evidence-based Practice (EBP) \9\ 186 2 0.30 112 37
and Trauma Informed Systems
Change Survey (ETSC)--
Administrator Version..........
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NCTSI Trainers
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Training Summary Form........... \10\ 124 5 0.2 124 41
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Service Providers Trained by NCTSI Centers
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Evidence-based Practice (EBP) \11\ 496 3 0.3 446 149
and Trauma Informed Systems
Change Survey (ETSC)--Provider
Version........................
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Training Participants
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Training Sign-In Sheet (TSIS)... \12\ 12,400 1 .02 248 83
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[[Page 53141]]
Mental Health and Non-Mental Health Professionals from State and National Child Serving Organizations
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NCTSI National Reach Survey..... 4,000 1 0.5 2,000 667
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Affiliate Center Administrators
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Sustainability Survey-- 45 3 .28 38 19
Affiliate Centers..............
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Total summary............... 71,857 66 .............. .............. 63,957
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Total annual summary.... 23,952 22 .............. .............. 21,319
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1. On average, 75 percent of centers participate in the Core Data Set (47 of 62 centers), with an average of 69
baseline visits per year.
2. On the basis of the children enrolled in the Core Data Set through September 30, 2010, the average length of
time in treatment is 9 months, yielding an average of 4 assessments per child.
3. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 76% of
the children in the Core Data Set will be ages 7 and older.
4. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 28% of
the children in the Core Data Set will be between the ages of 3 and 7.
5. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 60% of
the children in the Core Data Set will be aged 12 and under. We estimate that approximately 50% of centers
will use this optional instrument, leading to an estimate of 30% of children in the Core Data Set.
6. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 63% of
the children in the Core Data Set will be between the ages of 8 and 16.
7. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 44% of
the children in the Core Data Set will between the ages of 7 and 18, and will have depression indicated as a
potential problem at baseline. We estimate that approximately 50% of centers will use this optional
instrument, leading to an estimate of 22% of children in the Core Data Set.
8. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 41% of
the children in the Core Data Set will be aged 12 and older.
9. Respondents will be administrators from 62 currently funded NCTSI centers and administrators from two child
serving systems that each NCTSI center trains.
10. Respondents will be center trainers or evaluation staff. On average, 5 Training Summary Forms may be
completed by 124 trainers.
11. Respondents are NCTSI center employed clinicians and center trained providers. It is estimated that on
average from the 62 centers, four center-employed clinicians and four center trained providers will take the
survey three times.
12. It is expected that at least two trainers per center will provide five trainings and on an average there
will be twenty participants per training.
Written comments and recommendations concerning the proposed
information collection should be sent by September 26, 2011 to the
SAMHSA Desk Officer at the Office of Information and Regulatory
Affairs, Office of Management and Budget (OMB). To ensure timely
receipt of comments, and to avoid potential delays in OMB's receipt and
processing of mail sent through the U.S. Postal Service, commenters are
encouraged to submit their comments to OMB via e-mail to: [email protected]. Although commenters are encouraged to send
their comments via e-mail, commenters may also fax their comments to:
202-395-7285. Commenters may also mail them to: Office of Management
and Budget, Office of Information and Regulatory Affairs, New Executive
Office Building, Room 10102, Washington, DC 20503.
Dated: August 18, 2011.
Elaine Parry,
Director, Office of Management, Technology and Operations.
[FR Doc. 2011-21713 Filed 8-24-11; 8:45 am]
BILLING CODE 4162-20-P