[Federal Register Volume 88, Number 129 (Friday, July 7, 2023)]
[Notices]
[Pages 43353-43355]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-14412]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-23-1204]


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 ``Behavioral Risk Factor Surveillance System 
(BRFSS) Asthma Call-back Survey (ACBS)'' 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 March 6, 2023 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 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. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to ``http://www.reginfo.gov/public/doPRAMain''. Find this 
particular information collection by selecting ``Currently under 30-day 
Review--Open for Public Comments'' or by using the search function. 
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

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

[[Page 43354]]

Background and Brief Description

    The CDC's National Center for Environmental Health (NCEH) is 
requesting OMB approval for three years to revise and continue the 
``Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back 
Survey (ACBS)'' (OMB Control No. 0920-1204, Expiration Date 11/30/
2023). The ACBS is funded by the NCEH National Asthma Control Program 
(NACP) in the Asthma and Community Health Branch (ACHB) and is 
administered on behalf of NCEH by the CDC's National Center for Chronic 
Disease Prevention and Health Promotion (NCCDPHP) BRFSS Program. 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 administering both the BRFSS and 
the ACBS.
    The BRFSS (OMB Control No. 0920-1061, expiration date 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: screening, participation in a 
common BRFSS core survey, and participation in optional question 
modules that states use to customize survey content. The ACBS is a 
follow-up survey conducted in households that include an individual who 
has been diagnosed with asthma. 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 at 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 to reduce the burden of this disease. 
The CDC makes annual ACBS datasets available for public use and 
provides guidance on statistically appropriate uses of the data.
    In response to the contours of 2020 Terms of Clearance, the annual 
joint response rates from BRFSS and ACBS were reported with the ACBS 
annual dataset. To communicate the caveats of state-to-state 
comparisons, the ACBS nonresponse bias and impact on prevalence 
estimation are being analyzed and reported as appendix tables of 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-respondents 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.
    To provide clear communication about the caveats of state-to-state 
comparisons, the NACP revised the tables of prevalence estimates for 
asthma risk factors based on ACBS and reduced the number of risk 
factors prevalence tables from 20 to 13. The NACP also deleted the 
tables (active asthma related risk factors) that didn't provide enough 
information for state-to-state comparisons. A footnote with a hyperlink 
to the nonresponse report has been incorporated into the footnote for 
annual ACBS risk factors prevalence tables which can be viewed at: 
https://www.cdc.gov/brfss/acbs/2019_tables_LLCP.html.
    In addition, and also in response to the 2020 Terms of Clearance, 
the NACP undertook efforts to streamline the ACBS, reduce unnecessary 
burden, and ensure that the question wording is aligned with more 
recent studies. The questionnaires were re-evaluated by ACBS 
questionnaire working groups and the ACBS recipients. Beginning in 
2024, the NACP proposes a to delete 6 questions from the adult's 
questionnaire and 17 questions from child's questionnaire. The adult's 
questionnaire will include nine new questions and the child's 
questionnaire will include 10 new questions. The estimated time burden 
for the interview will remain unchanged from that of the 2021 
questionnaire (10 minutes per response). There are no proposed changes 
to the number of responses per respondent.
    The total BRFSS sample size decreased from 476,217 in 2016 to 
393,474 in 2020, and as a result of decreasing BRFSS sample size, the 
number of individuals eligible for the ACBS decreased from 46,100 to 
41,444 during that period. 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 estimated number of responses is 57,852, which is a 
decrease of 10,074 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 43355]]



                                        Estimated Annualized Burden Hours
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                                                                                                       Average
                                                                        Number of       Number of     burden per
          Type of respondents                     Form name            respondents    responses per    response
                                                                                       respondent     (in hours)
----------------------------------------------------------------------------------------------------------------
BRFSS Adults...........................  ACBS Landline Screener--             8,170               1         1/60
                                          Adult.
                                         ACBS Cell Phone Screener--          20,780               1         1/60
                                          Adult.
BRFSS Parents or Guardians of Children.  ACBS Landline Screener--               834               1         2/60
                                          Child.
                                         ACBS Cell Phone Screener--           4,109               1         2/60
                                          Child.
ACBS Adults............................  ACBS Adult Consent and              20,155               1        10/60
                                          Survey.
ACBS Parents or Guardians of Children..  ACBS Child Consent and               3,764               1        10/60
                                          Survey.
State BRFSS Coordinators...............  ACBS Adult Data Submission              40              12       155/60
                                          Layout.
                                         ACBS Child Data Submission              40              12        25/60
                                          Layout.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health 
Ethics and Regulations, Office of Science, Centers for Disease Control 
and Prevention.
[FR Doc. 2023-14412 Filed 7-6-23; 8:45 am]
BILLING CODE 4163-18-P