[Federal Register Volume 84, Number 57 (Monday, March 25, 2019)]
[Notices]
[Pages 11098-11099]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-05553]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-19-18APX]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Dental Survey: Improving Outpatient 
Antibiotic Use through Implementation and Evaluation of Core Elements 
of Outpatient Antibiotic Stewardship to the Office of Management and 
Budget (OMB) for review and approval. CDC previously published a 
``Proposed Data Collection Submitted for Public Comment and 
Recommendations'' notice on August 10, 2018 to obtain comments from the 
public and affected agencies. CDC did not receive comments related to 
the previous notice. This notice serves to allow an additional 30 days 
for public and affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including

[[Page 11099]]

whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) 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 submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to [email protected]. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202) 395-5806. Provide 
written comments within 30 days of notice publication.

Proposed Project

    Dental Survey: Improving Outpatient Antibiotic Use through 
Implementation and Evaluation of Core Elements of Outpatient Antibiotic 
Stewardship--New--Information Collection--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 time-frames 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 collection 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.
    There will be no anticipated costs to respondents other than their 
time. The survey will be voluntary and will be distributed within 
University of Utah dental clinics. Potential participants will be 
contacted via email informing them about the purpose of the survey. 
Participants would have the option of performing the survey online 
through an approved University of Utah survey platform (i.e. REDCap or 
Qualtrics) or on paper format if they prefer. To help increase response 
rate, paper formats may be distributed during dental staff meetings or 
any other gatherings within this population. Total burden hours being 
requested is 77.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondents                   Form name            Number of     responses per   per response
                                                                    respondents     respondent       (in hrs.)
----------------------------------------------------------------------------------------------------------------
Dental Providers......................  Recruitment during                   155               1           10/60
                                         meetings.
Dental Providers......................  SHEPheRD Outpatient                   25               1           30/60
                                         Dental Survey.
Dental Providers......................  Dental Survey--CDC                    75               1           30/60
                                         Outpatient SEPheRD--
                                         Practices and
                                         Experiences with
                                         Antibiotic Prescribing.
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2019-05553 Filed 3-22-19; 8:45 am]
BILLING CODE 4163-18-P