[Federal Register Volume 81, Number 44 (Monday, March 7, 2016)]
[Notices]
[Pages 11796-11798]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-04938]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-16-16RZ; Docket No. CDC-2016-0024]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing efforts to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies to take this opportunity to comment on proposed and/or 
continuing information collections, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on An Assessment of 
the State Public Health Actions (``1305'') Program, a study to explore 
state-level partnerships and synergy among state health departments 
funded through the State Public Health Actions 1305 cooperative 
agreement.

DATES: Written comments must be received on or before May 2, 2016.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2016-
0024 by any of the following methods:
    Federal eRulemaking Portal: Regulation.gov. Follow the instructions 
for submitting comments.
    Mail: Leroy A. Richardson, Information Collection Review Office, 
Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS-
D74, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. All relevant comments received will be posted 
without change to Regulations.gov, including any personal information 
provided. For access to the docket to read background documents or 
comments received, go to Regulations.gov.

    Please note: All public comment should be submitted through the 
Federal eRulemaking

[[Page 11797]]

portal (Regulations.gov) or by U.S. mail to the address listed 
above.


FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact the Information Collection Review Office, 
Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS-
D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: [email protected].

SUPPLEMENTARY INFORMATION: 
    Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-
3520), Federal agencies must obtain approval from the Office of 
Management and Budget (OMB) for each collection of information they 
conduct or sponsor. In addition, the PRA also requires Federal agencies 
to provide a 60-day notice in the Federal Register concerning each 
proposed collection of information, including each new proposed 
collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    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; (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; and (e) estimates of capital or start-
up costs and costs of operation, maintenance, and purchase of services 
to provide information. Burden means the total time, effort, or 
financial resources expended by persons to generate, maintain, retain, 
disclose or provide information to or for a Federal agency. This 
includes the time needed to review instructions; to develop, acquire, 
install and utilize technology and systems for the purpose of 
collecting, validating and verifying information, processing and 
maintaining information, and disclosing and providing information; to 
train personnel and to be able to respond to a collection of 
information, to search data sources, to complete and review the 
collection of information; and to transmit or otherwise disclose the 
information.

Proposed Project

    An Assessment of the State Public Health Actions (``1305'') 
Program--New--National Center for Chronic Disease Prevention and Health 
Promotion, Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Chronic diseases and conditions--such as heart disease, stroke, 
diabetes, and obesity--are the leading causes of death and disability 
in the United States, and are major drivers of sickness, disability, 
and high health care costs (CDC, 2016). Having multiple chronic 
conditions further increases the risk for these negative health 
outcomes, while also increasing risk for poor day-to-day functioning. 
Chronic diseases, as well as multiple chronic diseases, are associated 
with significant health care costs. In 2010, 86% of all health care 
spending was attributed to individuals with at least one chronic 
medical condition, and 71% was associated with care for individuals 
with multiple chronic conditions (Gerteis et al., 2014).
    To address these challenges, the Centers for Disease Control and 
Prevention (CDC)'s National Center for Chronic Disease Prevention and 
Health Promotion (NCCDPHP) provides funding for cross-cutting chronic 
disease programs within state and local health agencies to implement 
public health programs; conduct public health surveillance; translate 
research; communicate health prevention messages; and develop and 
implement tools and resources for state- and local-level stakeholders. 
In 2013, the NCCDPHP developed a new program funding opportunity to 
support states in the design and implementation of strategies to reduce 
complications from multiple chronic diseases and associated risk 
factors. The funding opportunity was announced as ``State Public Health 
Actions to Prevent and Control Diabetes, Heart Disease, Obesity and 
Associated Risk Factors and Promote School Health,'' CDC-RFA-DP13-1305, 
and is hereafter referred to as ``State Public Health Actions 1305.'' 
This new 5-year cooperative agreement supports state health departments 
in an important transition from funding and implementing four separate 
categorical areas (i.e., diabetes; heart disease and stroke; nutrition, 
physical activity, and obesity; and school health) to working 
collaboratively across categorical areas to plan and implement cross-
cutting initiatives. This cross-cutting approach is essential for 
supporting activities to prevent chronic disease and risk factors--
particularly multiple chronic conditions.
    State Public Health Actions 1305 addresses six key public health 
priorities: (1) Uncontrolled hypertension, (2) prevention and control 
of diabetes, (3) incidence of obesity, (4) increased physical activity 
and healthy eating by children and adults, (5) increased breastfeeding, 
and (6) improved management of chronic conditions among students. 
Strategies implemented under State Public Health Actions 1305 fall into 
one or more of four chronic disease domains, including (1) Epidemiology 
and Surveillance, (2) Environmental Approaches to promote health and 
support and reinforce healthful behaviors, (3) Health Systems 
Interventions to improve the effective delivery and use of clinical and 
other preventive services, and (4) Community-Clinical Linkages to 
support cardiovascular disease and diabetes prevention and control 
efforts, and the management of chronic diseases.
    Through this cooperative agreement, CDC currently provides over 
$100 million to state health departments in all 50 United States and 
the District of Columbia. Due to the funding, complexity, coordination, 
and collaboration needed to implement State Public Health Actions 1305, 
there are a number of semi-annual and annual reporting requirements 
related to categorical spending, chronic disease outcomes, 
efficiencies, and accomplishments. These routine reporting requirements 
allow CDC to monitor awardee progress towards programmatic goals, but 
do not collect specific information about the processes that support 
program implementation plans.
    The overall evaluation of State Public Health Actions 1305 examines 
the efficiency and effectiveness of the program to provide 
accountability, improve programs, expand practice-based evidence, and 
demonstrate health outcomes. An important component of assessing 
efficiency and effectiveness of the program is examining synergy. 
Synergy occurs when collaboration, coordination, alignment, and a 
combination of inputs and activities (i.e., the assets and skills of 
all the participating partners) produce outputs and outcomes greater 
than those that would have occurred if they had been used separately. 
The proposed strategies are intentionally aligned to attain greater 
success in achieving measurable outcomes that speak to the aims of each 
categorical area and the program as a whole. CDC proposes to conduct an 
assessment to better understand synergy

[[Page 11798]]

within and across State Public Health Actions 1305 funded programs.
    The assessment is guided by three process-related research 
questions and multiple indicators designed to examine changes in 
processes, organizational structure, and capacity. It will also examine 
states' ability to implement a coordinated approach across the 
different chronic disease areas and the four domains; challenges and 
benefits; and measurable positive outcomes. The research questions 
include: (1) What changes did States make to create greater synergy?, 
(2) To what extent were redundancies reduced or eliminated at the State 
level?, and (3) How has coordination with critical partners changed 
since the implementation of State Public Health Actions 1305?
    CDC plans to administer a web-based survey to health departments 
receiving funding through the State Public Health Actions 1305 
cooperative agreement, including 50 states and the District of 
Columbia. CDC plans to administer the survey in 2016 (program year 4) 
and 2018 (program year 5) to explore changes in partnerships and 
synergy throughout the 5-year cooperative agreement. Surveys will be 
administered to health department staff directly involved in planning 
and/or implementation of the State Public Health Actions 1305 program, 
including principal investigators, chronic disease directors, program 
evaluators, epidemiologists, and program staff with subject matter 
expertise in one or more of the four categorical areas. CDC will 
recruit approximately 8 individuals from each funded program for a 
total of approximately 408 respondents.
    CDC will use survey findings to (1) inform future CDC technical 
assistance provision to State Public Health Actions 1305 funded 
programs, and (2) inform future cross-cutting, coordinated funding 
models. In addition, findings will complement existing routine 
reporting by gathering information about the specific processes that 
support program implementation plans. Findings will be disseminated via 
grantee webinars, grantee annual meetings, reports to CDC leadership, 
and U.S. Congressional reports.
    OMB approval is requested for 2 years. Participation is voluntary 
and respondents will not receive incentives for participation. There 
are no costs to respondents other than their time.

                                        Estimated Annualized Burden Hours
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                                                                                      Average
                                                     Number of       Number of      burden per     Total  burden
     Type of  respondents           Form name       respondents    responses per   response  (in      (in hr)
                                                                    respondent          hr)
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Principal Investigators.......  Grantee Synergy               51               1           45/60              38
                                 Survey.
Chronic Disease Directors.....  Grantee Synergy               51               1           45/60              38
                                 Survey.
Program Evaluators............  Grantee Synergy               51               1           45/60              38
                                 Survey.
Epidemiologists...............  Grantee Synergy               51               1           45/60              38
                                 Survey.
Program Staff with Subject      Grantee Synergy              204               1           45/60             153
 Matter Expertise.               Survey.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............             305
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Leroy A. Richardson,
Chief, Information Collection Review Office, Office of Scientific 
Integrity, Office of the Associate Director for Science, Office of the 
Director, Centers for Disease Control and Prevention.
[FR Doc. 2016-04938 Filed 3-4-16; 8:45 am]
 BILLING CODE 4163-18-P