[Federal Register Volume 89, Number 7 (Wednesday, January 10, 2024)]
[Notices]
[Pages 1581-1583]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-00303]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    In compliance with section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995 concerning opportunity for public comment on proposed 
collections of information, the Substance Abuse and Mental Health 
Services Administration (SAMHSA) will publish periodic summaries of 
proposed projects. To request more information on the proposed projects 
or to obtain a copy of the information collection plans, contact the 
SAMHSA Reports Clearance Officer at [email protected].
    Comments are invited on: (a) whether the proposed collections of 
information are 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; and (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.

Project: 2023-2026 Advancing Wellness and Resilience in Education and 
Trauma Informed Services in Schools Cross-Site Evaluation--New 
Collection

    The Substance Abuse and Mental Health Services Administration 
(SAMHSA) Center for Mental Health Services (CMHS) is requesting 
clearance for data collection associated with a national cross-site 
evaluation of process, outcomes, and impact for the Advancing Wellness 
and Resilience in Education (hereinafter referred to as Project AWARE) 
and Trauma-Informed Services in Schools (TISS) programs.
    The purpose of the Project AWARE-TISS Cross-Site Evaluation is to 
better understand how each program is implemented, the extent to which 
they facilitate collaboration between education agencies and mental 
health systems, and how each program contributes to access and referral 
to mental health services and improved outcomes for youth.
    The AWARE-TISS Cross-Site Evaluation incorporates four evaluation 
components to provide a robust understanding of the implementation 
(process), outcomes, and associated impacts of the AWARE and TISS 
Programs and includes program-specific components to ensure 
programmatic differences and commonalities are understood. With this 
integrated evaluation design, SAMHSA maintains the ability to evaluate 
and report on each program separately, while additionally benefiting 
from the ability to understand the overarching impact of both programs 
collectively.
    Approval is being requested for data collection associated with a 
Process Evaluation and an Outcome Evaluation. Several program specific 
sub-studies and cross-program impact analyses will also be conducted to 
assess implementation and outcomes overall as well as those outcomes 
specific to high-need subpopulations and under-resourced communities. A 
behavioral health equity and cultural equity lens will be applied to 
each area of evaluation to ensure a culturally specific understanding 
of intervention implementation, outcomes, and impacts.
    The Process Evaluation will contain two studies (Implementation and 
Sustainability Study and Systems Change Study) that examine strategies 
common to both programs related to program implementation facilitators 
and barriers, workforce development, and grantees' plans to sustain 
critical program components beyond their grant period. This assessment 
of common elements will provide a means to compare the implementation 
strategies that are successful across both AWARE and TISS grantees and 
identify successes and challenges in changing systems, policies, 
service provision, and school climate; increasing behavioral health 
equity in access and service delivery; and increasing social and 
emotional development and well-being in school-aged children and youth. 
The Process Evaluation will also address implementation of program-
specific components.
    For AWARE, the evaluation will document how the grantees implement 
the three-tiered public health model in schools and the referral 
pathways to increase access to mental health promotion, prevention, and 
intervention. The evaluation will assess the grantee collaborative 
efforts and grantee activities intended to increase workforce capacity 
to identify the signs and symptoms of mental illness and ability to 
refer to appropriate services promptly.
    For TISS, the Process Evaluation will focus on examining what 
innovative strategies the grantees use to increase access to trauma 
informed services for school-aged youth and how the collaborative 
efforts of grantees and their partners develop/improve a school-based 
system for identification, referral, early intervention, treatment, and 
supportive services. Additionally, the Process Evaluation will assess 
the implementation of training to improve school capacity to address 
trauma support needs and engagement of families and communities to 
increase awareness of the effects of trauma on children and youth.
    The Outcome Evaluation will include two studies that examine 
important facets of the AWARE and TISS programs: (1) identification and 
referral infrastructure (Identification and Referral Study); and (2) 
youth resiliency and outcomes (Youth Resiliency and Outcomes Study). 
Both studies will provide critical information about the effectiveness 
of the AWARE and TISS programs in establishing and enhancing school-
based mental health supports for students.
    Program specific sub-studies, inclusive of two TISS case studies 
and an AWARE Suicide Awareness and Prevention Sub-Study, will be 
conducted to provide more extensive contextual and implementation 
information related to the AWARE and TISS programs.
    Finally, in addition to assessing the process and outcomes of each 
of the AWARE and TISS programs, we will

[[Page 1582]]

conduct two cross-program analyses that examine the associated impacts 
of the both programs on the establishment and enhancement of school-
based mental health supports for students (Cross-Program Impact 
Analysis) and the relationships of program and contextual factors with 
outcomes (Behavioral Health Equity Cross-Study Analysis).
    The proposed multimethod approach considers allowable and required 
activities, variation in the partnerships and provider networks/
infrastructure, program settings, populations being served, the range 
of program implementation plans and goals, existing data systems, and 
grant infrastructures that support implementation and evaluation 
participation. In addition, the design considers the stage of 
implementation of currently funded grantees to seamlessly integrate 
cohorts appropriately into the evaluation studies.
    Fourteen primary data collection activities compose the AWARE-TISS 
Cross-Site Evaluation.

Instrument Descriptions

    [ssquf] IS: The IS is a web-based survey that includes questions on 
protocols, policies, and structures present as part of schools' AWARE 
and TISS implementation processes; school/community integration; 
barriers and facilitators to implementation, and sustainability 
capacity. The survey also includes questions to gather program-specific 
information--for example, implementation of the pyramid model and 
suicide prevention policies in the case of AWARE grantees and details 
on trauma-informed services in the case of TISS grantees. The IS will 
be completed by project coordinator and program staff representatives 
annually. IS data will inform the Implementation and Sustainability 
Study, AWARE Suicide Awareness and Prevention Sub-Study and Behavioral 
Health Equity Cross-Study Analysis.
    [ssquf] IKII: Supplementing IS findings, IKIIs will be conducted to 
obtain in-depth information about AWARE and TISS program implementation 
and sustainability based on the perspectives of grantee program staff 
and local mental health system partner staff. In each year of the 3-
year data collection period, individual semi-structured interviews will 
be conducted with key representatives of each grantee's collaborative 
partnership group. Questions will focus on partnership development, 
coordination, and shared decision-making; perspectives on 
implementation including challenges, strategies, and successes; 
contextual, systems, or other factors that affect implementation; and 
approaches to planning for program sustainability. Interviews will be 
conducted in person during training and technical assistance (TTA) site 
visits or virtually when needed. IKII data will inform the 
Implementation and Sustainability Study, TISS Case Studies and 
Behavioral Health Equity Cross-Study Analysis.
    [ssquf] YFFG-Y and YFFG-F: The YFFG-Y and YFFG-F will be used to 
conduct focus groups with youth (aged 14-18 or older if appropriate) 
who attend schools implementing the AWARE or TISS programs and/or their 
parents/family representatives. The moderator guides will be semi-
structured and include open-ended questions to understand experiences 
and perspectives related to school climate, positive supports, youth or 
parent engagement, student resiliency and coping skills, awareness of 
school-based programs or resources to promote mental health literacy 
and meet mental health needs, mental health resource availability, and 
satisfaction with the program. Youth and family focus groups will be 
conducted annually and will include youth or parents representing a 
sample of AWARE and TISS grantees per year, such that all grantees will 
participate in the focus groups at least once during the evaluation. 
The YFFG-Y and YFFG-F will inform the Implementation and Sustainability 
Study and Behavioral Health Equity Cross-Study Analysis. Data collected 
through the YFFG-Y will also inform the Youth and Resiliency Outcomes 
Study.
    [ssquf] CPS: CPS is a web-based survey that assesses communication, 
working relationships, leadership, role-expectations, resources, and 
partner engagement/commitment. Respondents will also be asked whether 
their organization currently has a formal, signed memorandum of 
agreement with the grantee and what changes to policy and 
infrastructure have been made in the past year. State and local 
entities, including project coordinators, school administrators, and 
mental health providers, identified as partners by AWARE and TISS 
Grantees will be considered for participation. The CPS will be 
administered annually and will inform the Systems Change Study.
    [ssquf] TSF: TSF is a web-based form that will be used annually by 
AWARE and TISS grantees to document training and educational seminars. 
It will include training dates, length of time of training (in hours), 
topic of the training, training objectives, format of training delivery 
(in-person, webinar, online asynchronous, etc.), intended audience, and 
number of training participants. It is estimated that grantees will 
conduct up to 10 trainings annually for different groups (e.g., 
teachers, mental health professionals, instructional support 
personnel). The TSF will inform the Systems Change Study and AWARE 
Suicide Awareness and Prevention Sub-Study.
    [ssquf] PFF: The PFF is a web-based form that assesses perceptions 
of immediate and longer-term benefits in training areas that research 
has linked to effective implementation and practice change. The PFF 
will be completed annually by grantee training participants after 
training events to gather perception of the training experience and 
perceived feasibility of using the information. The PFF will inform the 
Systems Change Study.
    [ssquf] APPTS and TPPTS: The APPTS and TPPTS are web-based surveys 
intended to be taken before and after AWARE or TISS grantee trainings 
across the 3-year data collection period. The APPTS will be completed 
by a sample of training participants per AWARE grantee annually and 
assesses knowledge, attitudes, and beliefs related to identifying 
students in need of mental health services and referring them for 
mental health services, mental health literacy, attitudes, beliefs 
(including stigma), and self-efficacy to provide support and referrals 
to youth experiencing mental health symptoms. The TPPTS will be 
completed by sample of training participants per TISS grantee annually 
and assesses trainee's knowledge of and self-efficacy to use trauma-
informed strategies in their work. The APPTS and TPPTS will inform the 
Systems Change Study.
    [ssquf] WFS: The WFS is a web-based survey that assesses barriers 
and facilitators to training use and the extent to which participants 
identified students in need of mental health services and referred them 
to services. The WFS will be administered to approximately 50% of AWARE 
and TISS training participants that also completed the APPTS or TPPTS. 
The WFS will be completed 3- and 12-months after training events and 
will be used to measure behavioral changes and longer-term impact on 
systems and communities. The WFS will inform the Systems Change Study.
    [ssquf] STCSS, SSCSS, and PCSS: The STCSS, SSCSS, and PCSS are web-
based surveys assessing school climate and safety among students 
attending grantee LEAs, parents of students, school personnel, and LEA 
staff. Surveys will be administered in year one and in year three of 
the evaluation and assess availability and utilization of referral for

[[Page 1583]]

services (for students, parents, and school staff), trauma-informed 
practices (for school staff), respect for diversity (for school staff), 
racial climate (for students). The STCSS, SSCSS, and PCC will inform 
the Systems Change Study.
    [ssquf] SIRF: The SIRF is a web-based form that gathers existing 
data detailing each how youth in need of mental health, substance use, 
or trauma-specific support services were identified because of an AWARE 
or TISS program, whether and to which services youth were referred, and 
resulting services received. Establishing identification and referral 
systems, including coordination with support service providers equipped 
to meet the needs of youth, is a core component of AWARE and TISS grant 
requirements. The SIRF will be completed by grantee program staff for 
up to 100 youth annually per grantee as part of a record review for 
each youth identified and referred to support services. Information 
about the initial identification, including the location and pathway to 
identification (e.g., individual, screening tool, staff role), is 
obtained, along with information about referrals and support services 
received following identification. The form also includes deidentified 
demographic information about the youth receiving the identification, 
referral, and follow-up care. SIRF data can be extracted from case 
records of school-based care coordinators or mental health providers, 
or other existing data sources, including any school staff, support 
service provider, and family members who make a mental health, 
substance use, or trauma-related identification and referral. No 
personal identifiers are requested on the SIRF. SIRF data will inform 
the Identification and Referral Study and Behavioral Health Equity 
Cross-Study Analysis.
    The estimated response burden to collect this information 
associated with the AWARE-TISS Cross-Site Evaluation is as follows 
annualized over the requested 3-year clearance period is presented 
below. Annual Burden (hours) and Total Cost ($) are rounded to the 
nearest whole number.

                                            Total and Annualized Averages: Respondents, Responses, and Hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                    Responses      Total      Burden per   Annual     Hourly
               Instrument                     Type of respondent       Number of       per       number of     response    burden    wage rate    Total
                                                                      respondents   respondent   responses     (hours)     (hours)      ($)     cost ($)
--------------------------------------------------------------------------------------------------------------------------------------------------------
IS......................................  Project Coordinator.......          143            1          143          0.5        72  \1\ $35.52    $2,557
IS......................................  Program Staff.............           15            1           15          0.5         8   \2\ 21.71       174
IKII....................................  Project Coordinator.......           94            1           94            1        94       35.52     3,339
IKII....................................  Mental Health Provider....          141            1          141            1       141   \3\ 69.39     9,784
IKII....................................  School Administrator......           47            1           47            1        47   \4\ 54.21     2,548
YFFG-Y..................................  Youth.....................           79            1           79          1.5       119    \5\ 7.25       863
YFGG-F..................................  Parent of Youth...........           79            1           79          1.5       119        7.25       863
CPS.....................................  Project Coordinator.......          143            1          143         0.25        36       35.52     1,279
CPS.....................................  Program Staff.............           47            1           47         0.25        12       21.71       261
CPS.....................................  School Administrator......           47            1           47         0.25        12       54.21       651
TSF.....................................  Program Staff.............           47           10          470         0.15        71       21.71     1,541
PFF.....................................  Program Trainee...........        2,775            1        2,775         0.15       416   \6\ 26.81    11,153
APPTS...................................  Program Trainee...........        4,000            2        8,000         0.25     2,000       26.81    53,620
TPPTS...................................  Program Trainee...........          750            2        1,500         0.25       375       26.81    10,054
WFS.....................................  Program Trainee...........        2,391            2        4,782         0.25     1,196       26.81    32,065
PCSS....................................  Parent of Youth...........          282            1          282          0.4       113        7.25       819
STCSS...................................  Youth.....................          282            1          282          0.4       113        7.25       819
SSCSS...................................  School Staff..............          282            1          282          0.5       141   \7\ 30.20     4,258
SSCSS...................................  School Administrator......          188            1          188          0.5        94       54.21     5,096
SIRF....................................  Program Staff.............           47          100        4,700          0.5     2,350       21.71    51,019
    Total...............................  ..........................       11,879  ...........       24,096  ...........     7,529  ..........   192,763
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Community and Social Service
  Specialists, All Other (code 21-1099); https://www.bls.gov/oes/current/oes_nat.htm#21-0000.
\2\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Community and Social Service
  Assistants (code 21-1093); https://www.bls.gov/oes/current/oes_nat.htm#21-0000.
\3\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Healthcare Diagnosing or Treating
  Practitioners (code 29-1000); https://www.bls.gov/oes/current/naics5_541720.htm#29-0000.
\4\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Educational Administrators, All Other
  (code 11-9039); https://www.bls.gov/oes/current/naics5_541720.htm#11-0000.
\5\ https://www.usa.gov/minimum-wage.
\6\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Community and Social Service
  Occupations (code 21-0000); https://www.bls.gov/oes/current/oes_nat.htm#21-0000.
\7\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Educational, Guidance, and Career
  Counselors and Advisors (code 21-2012); https://www.bls.gov/oes/current/naics5_541720.htm#21-0000.

    Send comments to Carlos Graham, SAMHSA Reports Clearance Officer at 
[email protected]. Written comments should be received by March 
11, 2024.

Alicia Broadus,
Public Health Advisor.
[FR Doc. 2024-00303 Filed 1-9-24; 8:45 am]
BILLING CODE 4162-20-P