[Federal Register Volume 83, Number 155 (Friday, August 10, 2018)]
[Notices]
[Pages 39757-39758]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-17174]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-18-18APX; Docket No. CDC-2018-0066]


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 effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies the opportunity to comment on a proposed and/or 
continuing information collection, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on a proposed 
information collection project titled ``Dental Survey: Improving 
outpatient antibiotic use through implementation and evaluation of Core 
Elements of Outpatient Antibiotic Stewardship.'' This information 
collection request will generate data to assess knowledge, attitudes, 
practices and perceived barriers to appropriate antibiotic prescribing 
in a representative sample of dental providers. Results will be used to 
inform interventions for this specific provider population and support 
our efforts to improve antimicrobial stewardship within outpatient 
clinics.

DATES: CDC must receive written comments on or before October 9, 2018.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2018-
0066 by any of the following methods:
     Federal eRulemaking Portal: Regulations.gov. Follow the 
instructions for submitting comments.
     Mail: Jeffrey M. Zirger, 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. CDC will post, without change, all relevant comments 
to Regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
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 Jeffrey M. Zirger, 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

[[Page 39758]]

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 the 
OMB for approval. To comply with this requirement, we are publishing 
this notice of a proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.
    5. Assess information collection costs.

Proposed Project

    Dental Survey: Improving outpatient antibiotic use through 
implementation and evaluation of Core Elements of Outpatient Antibiotic 
Stewardship--New Information Collection Request--National Center for 
Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease 
Control and Prevention (CDC).

Background and Brief Description

    Antibiotic resistance is a growing problem that has been shown to 
be a result of wide-spread antibiotic use and misuse. While efforts to 
improve antibiotic use to date have been primarily implemented in the 
inpatient setting, the majority of antibiotics are prescribed in the 
outpatient setting. Up to 50% of all antibiotics prescribed for acute 
respiratory tract infections (ARI) are proposed to be inappropriate. 
Interventions that have been demonstrated to decrease inappropriate use 
include audit-and-feedback, academic detailing, clinical decision 
support systems (CDSS), provider-focused public commitments to reduce 
inappropriate antibiotic use, and delayed antibiotic prescriptions. 
However, current data is limited due to short study timeframes and lack 
of sustainability.
    In a pilot project, phone interviews were conducted with six dental 
providers and three pediatricians, specifically those who could speak 
to the knowledge, attitudes and behaviors of their peers. PRA was 
deemed not applicable by the NCEZID PRA representative for this pilot. 
We identified six dental providers that were recruited for a phone 
interview with our team's healthcare psychologist. Semi-structured 
interviews were used to assess: (1) Knowledge about antibiotic 
prescribing (what constitutes appropriate and inappropriate 
prescribing); (2) the providers current antibiotic prescribing 
practices; (3) beliefs about the consequences of inappropriate and 
appropriate prescribing (e.g., consequences for the provider, for 
individual patients, and for the healthcare system); (4) attitudes 
about antibiotic prescribing (expected negative and positive reactions 
to appropriate prescribing); (5) subjective norms (beliefs related to 
what is ``normal'' antibiotic prescribing for the provider and for 
peers); (6) control beliefs related to appropriate prescribing (factors 
that make appropriate prescribing easy or difficult, e.g., barriers); 
and (7) future planned behaviors along with perceived solutions to 
promote appropriate antibiotic prescribing.
    During the analysis of the six dental interviews it was determined 
by the team that these interviews contained very unique information in 
terms of knowledge, attitudes and behaviors compared to other non-
dental providers. Therefore, it was also determined that information 
saturation was not reached during this first data collection phase. We 
want to continue our data collect efforts within this specific 
population. This information will be crucial in future design of 
scalable and sustainable outpatient antibiotic stewardship 
interventions that incorporate all Core Elements of Outpatient 
Antibiotic Stewardship and to be able to implement it across a network 
of dental outpatient facilities.
    The total estimated annual Burden Hours are 50. There will be no 
anticipated costs to respondents other than their time.

                                                            Estimated Annualized Burden Hours
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                                                                                                             Number of    Average burden
              Type of respondents                               Form name                    Number of     responses per   per response    Total burden
                                                                                            respondents     respondent      (in hours)      (in hours)
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Dental Providers...............................  Dental Survey CDC Outpatient SHEPheRD..             100               1              .5              50
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    Total......................................  .......................................  ..............  ..............  ..............              50
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Jeffrey M. Zirger,
Acting 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. 2018-17174 Filed 8-9-18; 8:45 am]
 BILLING CODE 4163-18-P