[Federal Register Volume 88, Number 43 (Monday, March 6, 2023)]
[Notices]
[Pages 13825-13827]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-04491]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-23-1204; Docket No. CDC-2023-0013]


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 a continuing 
information collection, as required by the Paperwork Reduction Act of 
1995. This notice invites comment on a proposed data collection titled 
Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back 
Survey (ACBS). The ACBS is an in-depth asthma survey conducted on a 
subset of BRFSS respondents with an asthma diagnosis with the goal to 
strengthen the existing body of asthma data and to address critical 
questions surrounding the health and experiences of persons with 
asthma.

DATES: Written comments must be received on or before May 5, 2023.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2023-
0013 by any of the following methods:
     Federal eRulemaking Portal: www.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 H21-8, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to www.regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (www.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 H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7118; 
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 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;
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated,

[[Page 13826]]

electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses; and
    5. Assess information collection costs.

Proposed Project

    Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back 
Survey (ACBS) (OMB Control No. 0920-1204, Exp. 11/30/2023)--Revision--
National Center for Environmental Health (NCEH), Centers for Disease 
Control and Prevention (CDC).

Background and Brief Description

    The CDC's National Center for Environmental Health (NCEH) is 
requesting a three-year Paperwork Reduction Act (PRA) clearance to 
revise and continue to collect information under the Behavioral Risk 
Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS) (OMB 
Control No. 0920-1204, Exp. 11/30/2023). The ACBS is funded by the NCEH 
National Asthma Control Program (NACP) in the Asthma and Community 
Health Branch (ACHB).
    The ACBS is a follow-up survey on asthma and is administered on 
behalf of NCEH by the CDC's National Center for Chronic Disease 
Prevention and Health Promotion (NCCDPHP) BRFSS Program. The BRFSS (OMB 
Control No. 0920-1061, Exp. 12/31/2024) is a nationwide system of 
customized, cross-sectional telephone health surveys. The BRFSS 
information collection is conducted in a continuous, three-part 
telephone interview process: (1) screening; (2) participation in a 
common BRFSS core survey, and (3) participation in optional question 
modules that states use to customize survey content. BRFSS coordinators 
in the health departments in U.S. states, territories, and the District 
of Columbia (collectively referred to as ``states'' and 
``jurisdictions'') are responsible for both the BRFSS and the ACBS 
administration. The ACBS is conducted within two days after the BRFSS 
survey.
    The purpose of ACBS is to gather state-level asthma data and to 
make them available to track the burden of the disease, to monitor 
adherence to asthma guidelines, and to direct and evaluate 
interventions undertaken by asthma control programs located in state 
health departments. Beyond asthma prevalence estimates, for most 
states, the ACBS provides the only source of adult and child asthma 
data on the state and local level.
    Data collection for ACBS involves screening, obtaining permission, 
consenting, and telephone interviewing on a subset of the BRFSS 
respondents from participating states. The ACBS eligible respondents 
are BRFSS adults, 18 years and older, who report ever being diagnosed 
with asthma. In addition, some states include children, below 18 years 
of age, who are randomly selected subjects in the BRFSS household. 
Parents or guardians serve as ACBS proxy respondents for their children 
ever diagnosed with asthma. If both the BRFSS adult respondent and the 
selected child in the household have asthma, then only one or the other 
is eligible for the ACBS.
    State BRFSS Coordinators submit de-identified data files to CDC on 
a monthly or quarterly basis for cleaning and weighting. The CDC BRFSS 
ACBS operation team returns clean, weighted data files to the state of 
origin for its use. The ACBS adds considerable state-level depth to the 
existing body of asthma data. It addresses critical questions 
surrounding the health and experiences of persons with asthma. Health 
data include symptoms, environmental factors, and medication use among 
persons with asthma. Data on their experiences include activity 
limitation, health system use, and self-management education. These 
asthma data are needed to direct and evaluate interventions undertaken 
by asthma control programs located in state health departments. Federal 
agencies and other entities also rely on this critical information for 
planning and evaluating efforts and to reduce the burden from this 
disease. The CDC makes annual ACBS datasets available for public use 
and provides guidance on statistically appropriate uses of the data.
    Over the past three years, in response to the 2020 Terms of 
Clearance, the annual joint response rates from BRFSS and ACBS were 
reported with ACBS annual datasets. To communicate the caveats of 
state-to-state comparisons, the ACBS nonresponse bias and impact on 
prevalence estimation were analyzed and reported as appendix tables in 
the annual data quality report released with the public use dataset for 
adult and child participants (https://www.cdc.gov/brfss/acbs/2020/pdf/sdq_report_acbs_20-508.pdf). The first table reports unweighted and 
weighted demographic distribution percentages for each participating 
state based on BRFSS-eligible asthma respondents, non-responding to the 
ACBS, and ACBS final completes. The second table reports estimated 
current asthma percentage among individuals who have ever been 
diagnosed with asthma. These two tables will help communicate the 
potential impact of nonresponse bias on the ACBS published dataset.
    Furthermore, we revised the tables of prevalence estimates for 
asthma risk factors based on ACBS, reduced the number of risk factors 
prevalence tables from 20 to 13, and deleted the tables on active 
asthma related risk factors, which did not provide enough information 
to make state-to-state comparisons. A hyperlink to the nonresponse 
report have been included in the footnote for annual ACBS risk factors 
prevalence tables. The updated tables are available at: (https://www.cdc.gov/brfss/acbs/2020_tables_LLCP.html).
    The NACP undertook efforts to streamline the ACBS, to reduce 
unnecessary burden, and to ensure that the question wording is 
synchronized with more recent studies. The questionnaires were re-
evaluated by ACBS questionnaire working groups and the ACBS recipients. 
Question changes and additions to the 2024 ACBS questionnaire are as 
follows. A proposed total of six questions will be deleted from the 
adult's questionnaire and 17 questions will be deleted from the child's 
questionnaire. With the addition of nine new questions to the adult's 
questionnaire and 10 questions to the child's questionnaire, the 
estimated time burden for the interview will remain unchanged from that 
of the 2021 questionnaire (10 minutes per response).
    The total BRFSS sample size was reduced from 476,217 in 2016 to 
393,474 in 2020. As the result of decreasing BRFSS sample size, the 
number of eligible ACBS's BRFSS respondents changed from 46,100 to 
41,444 from 2016 to 2020. Although no revisions to the number of 
responses per respondent nor to the average time burden per response 
are requested, the NACP proposes the following changes to the burden 
estimation from 2021 (based on 2016 ACBS response data) to 2024 (based 
on 2020 response data). The total number of respondents is 58,292, 
which is a decrease of 10,554 from the previously approved 68,846. The 
total estimated annualized time burden is 6,073 hours, which is a 
decrease of 542 hours from the previously approved 6,615 hours. 
Participation in the ACBS is voluntary and there are no costs to 
respondents other than their time.

[[Page 13827]]



                                   Estimated Annualized Burden to Respondents
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                                                                     Number of    Average burden
      Type of respondents           Form name        Number of     responses per   per response    Total burden
                                                    respondents     respondent       (in hrs.)         hours
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BRFSS Adults..................  ACBS Landline              8,170               1            1/60             136
                                 Screener--Adult.
                                ACBS Cell Phone           20,780               1            1/60             346
                                 Screener--Adult.
BRFSS Parents or Guardians of   ACBS Landline                834               1            2/60              28
 Children.                       Screener--Child.
                                ACBS Cell Phone            4,109               1            2/60             137
                                 Screener--Child.
ACBS Adults...................  ACBS Adult                20,155               1           10/60           3,359
                                 Consent and
                                 Survey.
ACBS Parents or Guardians of    ACBS Child                 3,764               1           10/60             627
 Children.                       Consent and
                                 Survey.
State BRFSS Coordinators......  ACBS Data                     40              12               3           1,440
                                 Submission
                                 Layout.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............           6,073
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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. 2023-04491 Filed 3-3-23; 8:45 am]
BILLING CODE 4163-18-P