80_FR_30177 80 FR 30077 - Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Spousal Influence on Consumer Understanding of and Response to Direct-to-Consumer Prescription Drug Advertisements

80 FR 30077 - Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Spousal Influence on Consumer Understanding of and Response to Direct-to-Consumer Prescription Drug Advertisements

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 80, Issue 100 (May 26, 2015)

Page Range30077-30080
FR Document2015-12582

The Food and Drug Administration (FDA) is announcing that a proposed collection of information has been submitted to the Office of Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995.

Federal Register, Volume 80 Issue 100 (Tuesday, May 26, 2015)
[Federal Register Volume 80, Number 100 (Tuesday, May 26, 2015)]
[Notices]
[Pages 30077-30080]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-12582]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2014-N-1819]


Agency Information Collection Activities; Submission for Office 
of Management and Budget Review; Comment Request; Spousal Influence on 
Consumer Understanding of and Response to Direct-to-Consumer 
Prescription Drug Advertisements

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

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

SUMMARY: The Food and Drug Administration (FDA) is announcing that a 
proposed collection of information has been submitted to the Office of 
Management and Budget (OMB) for review and clearance under the 
Paperwork Reduction Act of 1995.

DATES: Fax written comments on the collection of information by June 
25, 2015.

ADDRESSES: To ensure that comments on the information collection are 
received, OMB recommends that written comments be faxed to the Office 
of Information and Regulatory Affairs, OMB, Attn: FDA Desk Officer, 
FAX: 202-395-7285, or emailed to oira_submission@omb.eop.gov. All 
comments should be identified with the OMB control number 0910-NEW and 
title ``Spousal Influence on Consumer Understanding of and Response to 
Direct-to-Consumer (DTC) Prescription Drug Advertisements''. Also 
include the FDA docket number found in brackets in the heading of this 
document.

FOR FURTHER INFORMATION CONTACT: FDA PRA Staff, Office of Operations, 
Food and Drug Administration, 8455 Colesville Rd., COLE-14526, Silver 
Spring, MD 20993-0002, PRAStaff@fda.hhs.gov.

SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, FDA has 
submitted the following proposed collection of information to OMB for 
review and clearance.

Spousal Influence on Consumer Understanding of and Response to Direct-
to-Consumer Prescription Drug Advertisements--(OMB Control Number 0910-
NEW)

    Section 1701(a)(4) of the Public Health Service Act (42 U.S.C. 
300u(a)(4)) authorizes FDA to conduct research relating to health 
information. Section 1003(d)(2)(C) of the Federal Food, Drug, and 
Cosmetic Act (the FD&C Act) (21 U.S.C. 393(d)(2)(C)) authorizes FDA to 
conduct research relating to drugs and other FDA regulated products in 
carrying out the provisions of the FD&C Act.
    Consumers are often thought of as individual targets for 
prescription drug advertisements (ads), as if they are always exposed 
to DTC ads individually and subsequently make judgments about 
advertised products on their own. However, judgments about prescription 
drugs portrayed in DTC television ads are likely made in social 
contexts much of the time. For example, a potential consumer and his or 
her spouse (e.g., marital or domestic partner) may view an ad together 
and discuss drug benefits, side effects, and risks. These social 
interactions may result in unique reactions relative to consumers who 
view DTC prescription drug television ads alone. For example, spouses 
may influence their partner by expressing concern about risks and side 
effects that might occur, or pressuring their partner to consider the 
drug despite its risks and side effects. These outcomes have important 
public health implications. The Office of Prescription Drug Promotion 
plans to examine differences between consumers viewing prescription 
drug ads with a spouse versus alone through empirical research.
    The main study will be preceded by pretesting designed to delineate 
the procedures and measures used in the main study. Pretest and main 
study participants will be couples who are married or in a marital-like 
living arrangement in which one member (consumer) has asthma and the 
other does not (spouse). All participants will be 18 years of age or 
older and married or cohabiting for 6 months or longer. We will exclude 
individuals who work in

[[Page 30078]]

healthcare or marketing settings because their knowledge and 
experiences may not reflect those of the average consumer. Data 
collection will take place in person.
    Participants will be randomly assigned to one of four experimental 
conditions in a 2 x 2 design, as depicted in Table 1. We will compare 
one version of an ad that depicts a low benefit and low risk drug with 
a second version that depicts a high benefit and high risk drug. 
Participants will be randomly assigned to view the ad alone or together 
with their spouse. Participants in both viewing conditions will 
individually complete a prequestionnaire. In the ``together'' 
condition, participants will view the ad with their spouse and then 
engage in a brief discussion together about the ad. In the ``alone'' 
condition, participants will view the ad without their spouse, take a 
short break, and then respond to a postquestionnaire consisting of 
questions about information in the ad. The short break in the ``alone'' 
condition will facilitate reflection about the ad to mirror discussion 
engaged in by those in the ``together'' condition. The consumer in the 
``together'' condition will complete the same postquestionnaire 
administered to those in the ``alone'' condition, and the spouse will 
complete a slightly different questionnaire that assesses key measures 
that relate to consumer reactions. These procedures are depicted in 
Table 2. Participation is estimated to take approximately 60 minutes.
    Measures are designed to assess memory and understanding of risk 
and benefit information as well as other ad content, intention to seek 
more information about the product, and variables pertaining to the 
consumer-spouse relationship such as relationship closeness and 
communication style. The questionnaire is available upon request.

                   Table 1--Experimental Study Design
------------------------------------------------------------------------
                                          Risk/benefit condition
                                 ---------------------------------------
        Viewing condition            Low risk/low       High risk/high
                                        benefit             benefit
------------------------------------------------------------------------
Alone...........................  Condition A.......  Condition B
Together........................  Condition C.......  Condition D
------------------------------------------------------------------------


   Table 2--Overview of Data Collection Process for Alone and Together
                               Conditions
------------------------------------------------------------------------
                                           Viewing condition
            Steps            -------------------------------------------
                                      Alone               Together
------------------------------------------------------------------------
1...........................  Consumer completes    Consumer and spouse
                               prequestionnaire.     complete
                                                     prequestionnaire
                                                     separately (spouse
                                                     completes selected
                                                     measures).
2...........................  Consumer views        Consumer and spouse
                               advertising stimuli   view advertising
                               alone.                stimuli together.
3...........................  5 minute break......  Couples engage in a
                                                     5 minute semi-
                                                     structured
                                                     conversation
                                                     related to the
                                                     advertising
                                                     stimuli.
4...........................  Consumer completes    Consumer and spouse
                               postquestionnaire.    complete
                                                     postquestionnaire
                                                     separately (spouse
                                                     completes selected
                                                     measures).
------------------------------------------------------------------------

    In the Federal Register of November 14, 2014 (79 FR 68278), FDA 
published a 60-day notice requesting public comment on the proposed 
collection of information. FDA received comments from two organizations 
in response to our Federal Register notice. In the following section, 
we outline the observations and suggestions raised in the comments and 
provide our responses.
    (Comment from Abbvie) It is difficult to ascertain how the Agency 
will utilize the results of this study should it demonstrate that the 
perception of ads differs when viewed alone or with someone else. 
Regulating companion versus solitary viewing practices would present 
insurmountable legal and practical hurdles. Rather than conduct this 
study, we suggest that FDA resources and tax payer dollars would be 
better directed to research that enhances the quality of how we 
communicate benefit and risk information to consumers regardless of the 
setting in which the ad is viewed.
    (Response) Much research in the social sciences demonstrates the 
strong influence of environmental and social conditions under which 
humans think and act. In regard to prescription drug advertising, it 
may be that when a risk is perceived as particularly negative, viewing 
with a partner reinforces this perception. Conversely, it may be that 
partners downplay risks or emphasize benefits, leading to alternate 
perceptions and intentions. These potential outcomes have implications 
for public health. Thus, it is important to generate insight about not 
only the message portrayed in DTC TV ads but also the conditions under 
which these messages are received and processed. Pending findings from 
this research, organizations involved in developing DTC drug 
communications may be encouraged to remain aware of the social context 
in which DTC ads are often viewed and the influence of this context on 
consumer perceptions, judgments, and decisions. Consideration of this 
broader context may facilitate the development of better DTC drug 
communications that remain accurate and balanced regardless of setting.
    (Comment from Eli Lilly) Compelling a discussion between the 
consumer and spouse about the advertisement is likely to generate data 
that may or may not be applicable in a real-world setting. Consider 
removing the prescribed interaction and allow a discussion to occur if 
the couple so chooses.
    (Response) Allowing a discussion to occur if the couple chooses 
could confound the research design and undermine our ability to make 
conclusive statements. Implementing the procedures systematically 
across the sample is a stronger study design (Ref. 1). There is a long 
tradition in the social and behavioral sciences of studying marital 
communication as proposed (Ref. 2). This research tradition continues 
because this method is more objective than participant self-reports 
(Ref. 3). Also, measures taken from these spousal communications are 
linked with important real world outcomes including health behavior and 
well-being (Ref. 4, Ref. 5), divorce, and marital satisfaction (Ref. 6, 
Ref. 2). This research method compels a discussion between partners as 
a way to understand the content and style of their communication. Thus, 
our proposed study is in keeping with the methods in this research 
area.
    (Comment from Eli Lilly) We are challenged to understand how this 
research yields any useful, actionable information when it is 
impractical to

[[Page 30079]]

influence who is watching TV advertisements at any given time.
    (Response) As stated in response to a previous comment, it is 
important to generate insight about not only the message portrayed in 
DTC TV ads but also the conditions under which these messages are 
received and processed. Such insight may facilitate the development of 
better DTC drug communications regardless of setting.
    (Comment from Eli Lilly) Include a ``General Population'' control 
group.
    (Response) Researching each medical condition, or general 
population sample, requires significant resources. We are interested in 
response to the ads among consumers for whom the ad is personally 
relevant (i.e., they or their partner have been diagnosed with asthma). 
We are committed to conducting this research using our available 
resources while ensuring the integrity of the research by collecting 
data on a high prevalence condition for which participants might be 
thought of as sufficiently representative of the average consumer, thus 
allowing us to draw conclusions about broad perceptual and cognitive 
processing outcomes.
    (Comment from Eli Lilly) Q12 invites speculation from respondents 
who may be unable to evaluate what is or is not a ``serious'' side 
effect. Consider eliminating this question or re-phrasing to: ``Please 
rate the seriousness of the side effects for [Drug X] that you remember 
from the ad.''
    (Response) We have conducted cognitive interviews to refine and 
improve the survey questions. Through this process, we found that a 
number of participants had difficulty reading and/or answering Q12 in 
its original form. We also tested an alternative version of this 
question that conforms to the reviewer's re-phrasing, ``In your 
opinion, how serious are the side effects of [Drug X]?'' Many cognitive 
interview participants preferred this alternative version, and we will 
adopt it for the final questionnaire.
    (Comment from Eli Lilly) Response options in Q16 may be interpreted 
qualitatively (i.e., on the whole, the risks outweigh the benefits) or 
literally (i.e., how many more risks were stated than benefits). 
Rephrasing to reflect true intent is recommended.
    (Response) We appreciate this comment. This item was tested in a 
rigorous cognitive interview protocol and there was no indication that 
participants had difficulty interpreting the response options. However, 
we will also be conducting pretesting which will provide an additional 
opportunity to identify and remove questions that do not function as 
intended, further refining the questionnaire prior to the main study.
    (Comment from Eli Lilly) Q19b is ambiguous and unclear. Rephrasing 
or deletion is recommended.
    (Response) We tested this item as part of our cognitive interview 
protocol. The majority of participants understood this question, and 
their answers suggest that the question did a good job of 
distinguishing between those who focused on the arguments and facts 
presented in the ad versus those who paid more attention to peripheral 
cues, such as the visual narrative. Because the item functioned as 
intended, we intend to retain Q19b.
    (Comment from Eli Lilly) Q20 is ambiguous and unclear. Rephrasing 
or deletion is recommended.
    (Response) In our cognitive interviews, some participants had 
difficulty understanding the meaning of the introductory phrase ``In 
these thoughts''. Due to the ambiguity of Q20 as a whole, we will 
remove this item from the questionnaire.
    (Comment from Eli Lilly) Q21 instructions could bias respondents to 
evaluate each statement as risk-related. Consider rephrasing to, ``The 
following statements describe how people deal with various 
situations.''
    (Response) The Q21 battery is a validated scale specifically 
designed to measure attitudes toward risk (Ref. 7). Respondents are 
meant to evaluate the statements as though they are risk-related. 
Therefore, we will retain the Q21 battery.
    (Comment from Eli Lilly) The scale for Q25 should be made 
consistent with other scales to ensure internal consistency. A scale 
with a midpoint is recommended.
    (Response) When developing the questionnaires, we included a number 
of questions from existing multi-items scales. The number and format of 
response options differed from scale to scale (e.g., 6-points vs. 10-
points, fully labelled vs. anchors-only, etc.). We will revise the 
Likert-type response scales so that the number of levels and labeling 
formats across questions is consistent.
    To examine differences between experimental conditions, we will 
conduct inferential statistical tests such as analysis of variance. 
With the sample size described in Table 3, we will have sufficient 
power to detect small-to-medium sized effects in the main study.
    FDA estimates the burden of this collection of information as 
follows:

                                 Table 3--Estimated Annual Reporting Burden \1\
----------------------------------------------------------------------------------------------------------------
                                                    Number of
                                       Number of    responses      Total       Average burden per
              Activity                respondents      per         annual           response         Total hours
                                                    respondent   responses
----------------------------------------------------------------------------------------------------------------
                                                   Pretesting
----------------------------------------------------------------------------------------------------------------
Number to Complete the Screener.....          700            1          700  0.08 (5 minutes)......           56
Number of Completes.................          120            1          120  1.....................          120
----------------------------------------------------------------------------------------------------------------
                                                   Main Study
----------------------------------------------------------------------------------------------------------------
Number to Complete the Screener.....        4,060            1        4,060  0.08 (5 minutes)......          325
Number of Completes.................          792            1          792  1.....................          792
                                     ---------------------------------------------------------------------------
    Total...........................  ...........  ...........  ...........  ......................        1,293
----------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of
  information.

References

    The following references have been placed on display in the 
Division of Dockets Management (see ADDRESSES) and may be seen by 
interested persons between 9 a.m. and 4 p.m., Monday through Friday, 
and are available electronically at http://www.regulations.gov. (FDA 
has verified all the Web site addresses in this reference section, 
but we are not responsible for any

[[Page 30080]]

subsequent changes to the Web sites after this document publishes in 
the Federal Register.)

Reis, H., and C. Judd, Handbook of Research Methods in Social and 
Personality Psychology, 2nd Ed. New York: Cambridge University Press 
(2014).
Kerig, P.K., and D.H. Baucom, (Eds.). Couple Observational Coding 
Systems, Mahwah, NJ: Erlbaum (2004).
Bakeman, R., Behavioral Observation and Coding, In H.T. Reis & C.M. 
Judd (Eds.) Handbook of Research Methods in Social and Personality 
Psychology,pp. 138-159. New York: Cambridge University Press (2000).
Ewart, C.K., C.B. Taylor, H.C. Kraemer, and W.S. Agras. ``High Blood 
Pressure and Marital Discord: Not Being Nasty Matters More Than 
Being Nice,'' Health Psychology, 10, pp. 155-163 (1991).
Spitzberg, B.H., and W.R. Cupach, Handbook of Interpersonal 
Competence Research, NY: Springer-Verlag (1989).
Gottman, J.M., What Predicts Divorce? The Relationship Between 
Marital Processes and Marital Outcomes. Hillsdale, NJ: Erlbaum 
(1994).
Rohrmann, B., ``Risk Attitude Scales: Concepts, Questionnaires, 
Utilizations [Project Report],'' University of Melbourne, Australia. 
Retrieved from http://www.rohrmannresearch.net/pdfs/rohrmann-racreport.pdf (2005).

    Dated: May 18, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015-12582 Filed 5-22-15; 8:45 am]
 BILLING CODE 4164-01-P



                                                                                         Federal Register / Vol. 80, No. 100 / Tuesday, May 26, 2015 / Notices                                                            30077

                                                  policies to assist victims of human                                    Respondents: Individual participants
                                                  trafficking.                                                         in TVAP projects.

                                                                                                                                ANNUAL BURDEN ESTIMATES
                                                                                                                                                                                   Number of            Average
                                                                                                                                                                 Number of                                           Total burden
                                                                                                Instrument                                                                       responses per        burden hours
                                                                                                                                                                respondents                                             hours
                                                                                                                                                                                   respondent         per response

                                                  Request for Information ...................................................................................         1250              1                 .25           312.5



                                                    Estimated Total Annual Burden                                      DEPARTMENT OF HEALTH AND                                     Spousal Influence on Consumer
                                                  Hours: 312.5.                                                        HUMAN SERVICES                                               Understanding of and Response to
                                                    In compliance with the requirements                                                                                             Direct-to-Consumer Prescription Drug
                                                                                                                       Food and Drug Administration                                 Advertisements—(OMB Control
                                                  of Section 506(c)(2)(A) of the Paperwork
                                                                                                                                                                                    Number 0910–NEW)
                                                  Reduction Act of 1995, the
                                                  Administration for Children and                                      [Docket No. FDA–2014–N–1819]                                   Section 1701(a)(4) of the Public
                                                  Families is soliciting public comment                                                                                             Health Service Act (42 U.S.C.
                                                                                                                       Agency Information Collection                                300u(a)(4)) authorizes FDA to conduct
                                                  on the specific aspects of the                                       Activities; Submission for Office of
                                                  information collection described above.                                                                                           research relating to health information.
                                                                                                                       Management and Budget Review;                                Section 1003(d)(2)(C) of the Federal
                                                  Copies of the proposed collection of                                 Comment Request; Spousal Influence
                                                  information can be obtained and                                                                                                   Food, Drug, and Cosmetic Act (the
                                                                                                                       on Consumer Understanding of and                             FD&C Act) (21 U.S.C. 393(d)(2)(C))
                                                  comments may be forwarded by writing                                 Response to Direct-to-Consumer                               authorizes FDA to conduct research
                                                  to the Administration for Children and                               Prescription Drug Advertisements                             relating to drugs and other FDA
                                                  Families, Office of Planning, Research                                                                                            regulated products in carrying out the
                                                  and Evaluation, 370 L’Enfant                                         AGENCY:       Food and Drug Administration,
                                                                                                                       HHS.                                                         provisions of the FD&C Act.
                                                  Promenade SW., Washington, DC 20447,                                                                                                Consumers are often thought of as
                                                  Attn: ACF Reports Clearance Officer.                                 ACTION:      Notice.                                         individual targets for prescription drug
                                                  Email address: infocollection@                                                                                                    advertisements (ads), as if they are
                                                  acf.hhs.gov. All requests should be                                  SUMMARY:   The Food and Drug
                                                                                                                                                                                    always exposed to DTC ads individually
                                                                                                                       Administration (FDA) is announcing
                                                  identified by the title of the information                                                                                        and subsequently make judgments about
                                                                                                                       that a proposed collection of
                                                  collection.                                                                                                                       advertised products on their own.
                                                                                                                       information has been submitted to the
                                                    The Department specifically requests                                                                                            However, judgments about prescription
                                                                                                                       Office of Management and Budget
                                                  comments on: (a) Whether the proposed                                                                                             drugs portrayed in DTC television ads
                                                                                                                       (OMB) for review and clearance under
                                                                                                                                                                                    are likely made in social contexts much
                                                  collection of information is necessary                               the Paperwork Reduction Act of 1995.
                                                                                                                                                                                    of the time. For example, a potential
                                                  for the proper performance of the                                    DATES: Fax written comments on the                           consumer and his or her spouse (e.g.,
                                                  functions of the agency, including                                   collection of information by June 25,                        marital or domestic partner) may view
                                                  whether the information shall have                                   2015.                                                        an ad together and discuss drug
                                                  practical utility; (b) the accuracy of the                                                                                        benefits, side effects, and risks. These
                                                                                                                       ADDRESSES:   To ensure that comments on
                                                  agency’s estimate of the burden of the                                                                                            social interactions may result in unique
                                                                                                                       the information collection are received,
                                                  proposed collection of information; (c)                                                                                           reactions relative to consumers who
                                                                                                                       OMB recommends that written
                                                  the quality, utility, and clarity of the                                                                                          view DTC prescription drug television
                                                                                                                       comments be faxed to the Office of
                                                  information to be collected; and (d)                                 Information and Regulatory Affairs,                          ads alone. For example, spouses may
                                                  ways to minimize the burden of the                                   OMB, Attn: FDA Desk Officer, FAX:                            influence their partner by expressing
                                                  collection of information on                                         202–395–7285, or emailed to oira_                            concern about risks and side effects that
                                                  respondents, including through the use                               submission@omb.eop.gov. All                                  might occur, or pressuring their partner
                                                  of automated collection techniques or                                comments should be identified with the                       to consider the drug despite its risks and
                                                  other forms of information technology.                               OMB control number 0910–NEW and                              side effects. These outcomes have
                                                  Consideration will be given to                                       title ‘‘Spousal Influence on Consumer                        important public health implications.
                                                  comments and suggestions submitted                                   Understanding of and Response to                             The Office of Prescription Drug
                                                  within 60 days of this publication.                                  Direct-to-Consumer (DTC) Prescription                        Promotion plans to examine differences
                                                                                                                       Drug Advertisements’’. Also include the                      between consumers viewing
                                                  Robert Sargis,                                                                                                                    prescription drug ads with a spouse
                                                                                                                       FDA docket number found in brackets
                                                  Reports Clearance Officer.                                           in the heading of this document.                             versus alone through empirical research.
                                                  [FR Doc. 2015–12591 Filed 5–22–15; 8:45 am]                                                                                         The main study will be preceded by
                                                                                                                       FOR FURTHER INFORMATION CONTACT: FDA
                                                  BILLING CODE 4184–01–P                                                                                                            pretesting designed to delineate the
                                                                                                                       PRA Staff, Office of Operations, Food                        procedures and measures used in the
                                                                                                                       and Drug Administration, 8455                                main study. Pretest and main study
                                                                                                                       Colesville Rd., COLE–14526, Silver
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                                                                                                                                                    participants will be couples who are
                                                                                                                       Spring, MD 20993–0002, PRAStaff@                             married or in a marital-like living
                                                                                                                       fda.hhs.gov.                                                 arrangement in which one member
                                                                                                                       SUPPLEMENTARY INFORMATION:    In                             (consumer) has asthma and the other
                                                                                                                       compliance with 44 U.S.C. 3507, FDA                          does not (spouse). All participants will
                                                                                                                       has submitted the following proposed                         be 18 years of age or older and married
                                                                                                                       collection of information to OMB for                         or cohabiting for 6 months or longer. We
                                                                                                                       review and clearance.                                        will exclude individuals who work in


                                             VerDate Sep<11>2014       17:50 May 22, 2015       Jkt 235001      PO 00000      Frm 00041      Fmt 4703     Sfmt 4703    E:\FR\FM\26MYN1.SGM   26MYN1


                                                  30078                                      Federal Register / Vol. 80, No. 100 / Tuesday, May 26, 2015 / Notices

                                                  healthcare or marketing settings because                                 In the ‘‘alone’’ condition, participants                           Measures are designed to assess
                                                  their knowledge and experiences may                                      will view the ad without their spouse,                           memory and understanding of risk and
                                                  not reflect those of the average                                         take a short break, and then respond to                          benefit information as well as other ad
                                                  consumer. Data collection will take                                      a postquestionnaire consisting of                                content, intention to seek more
                                                  place in person.                                                         questions about information in the ad.                           information about the product, and
                                                    Participants will be randomly                                          The short break in the ‘‘alone’’                                 variables pertaining to the consumer-
                                                  assigned to one of four experimental                                     condition will facilitate reflection about                       spouse relationship such as relationship
                                                  conditions in a 2 x 2 design, as depicted                                the ad to mirror discussion engaged in                           closeness and communication style. The
                                                  in Table 1. We will compare one version
                                                                                                                           by those in the ‘‘together’’ condition.                          questionnaire is available upon request.
                                                  of an ad that depicts a low benefit and
                                                                                                                           The consumer in the ‘‘together’’
                                                  low risk drug with a second version that
                                                  depicts a high benefit and high risk                                     condition will complete the same                                     TABLE 1—EXPERIMENTAL STUDY
                                                  drug. Participants will be randomly                                      postquestionnaire administered to those                                       DESIGN
                                                  assigned to view the ad alone or                                         in the ‘‘alone’’ condition, and the
                                                  together with their spouse. Participants                                 spouse will complete a slightly different                                                  Risk/benefit condition
                                                                                                                           questionnaire that assesses key                                      Viewing
                                                  in both viewing conditions will                                                                                                              condition           Low risk/low    High risk/high
                                                  individually complete a                                                  measures that relate to consumer                                                          benefit          benefit
                                                  prequestionnaire. In the ‘‘together’’                                    reactions. These procedures are
                                                  condition, participants will view the ad                                 depicted in Table 2. Participation is                            Alone ............    Condition A ..   Condition B
                                                  with their spouse and then engage in a                                   estimated to take approximately 60                               Together .......      Condition C ..   Condition D
                                                  brief discussion together about the ad.                                  minutes.

                                                                          TABLE 2—OVERVIEW OF DATA COLLECTION PROCESS FOR ALONE AND TOGETHER CONDITIONS
                                                                                                                                                                     Viewing condition
                                                                    Steps
                                                                                                                                     Alone                                                                       Together

                                                  1 ...........................................   Consumer completes prequestionnaire ..........................                    Consumer and spouse complete prequestionnaire sep-
                                                                                                                                                                                      arately (spouse completes selected measures).
                                                  2 ...........................................   Consumer views advertising stimuli alone ......................                   Consumer and spouse view advertising stimuli to-
                                                                                                                                                                                      gether.
                                                  3 ...........................................   5 minute break ................................................................   Couples engage in a 5 minute semi-structured con-
                                                                                                                                                                                      versation related to the advertising stimuli.
                                                  4 ...........................................   Consumer completes postquestionnaire .........................                    Consumer and spouse complete postquestionnaire sep-
                                                                                                                                                                                      arately (spouse completes selected measures).



                                                     In the Federal Register of November                                   advertising, it may be that when a risk                          interaction and allow a discussion to
                                                  14, 2014 (79 FR 68278), FDA published                                    is perceived as particularly negative,                           occur if the couple so chooses.
                                                  a 60-day notice requesting public                                        viewing with a partner reinforces this                             (Response) Allowing a discussion to
                                                  comment on the proposed collection of                                    perception. Conversely, it may be that                           occur if the couple chooses could
                                                  information. FDA received comments                                       partners downplay risks or emphasize                             confound the research design and
                                                  from two organizations in response to                                    benefits, leading to alternate perceptions                       undermine our ability to make
                                                  our Federal Register notice. In the                                      and intentions. These potential                                  conclusive statements. Implementing
                                                  following section, we outline the                                        outcomes have implications for public                            the procedures systematically across the
                                                  observations and suggestions raised in                                   health. Thus, it is important to generate                        sample is a stronger study design (Ref.
                                                  the comments and provide our                                             insight about not only the message                               1). There is a long tradition in the social
                                                  responses.                                                               portrayed in DTC TV ads but also the                             and behavioral sciences of studying
                                                     (Comment from Abbvie) It is difficult                                 conditions under which these messages                            marital communication as proposed
                                                  to ascertain how the Agency will utilize                                 are received and processed. Pending                              (Ref. 2). This research tradition
                                                  the results of this study should it                                      findings from this research,                                     continues because this method is more
                                                  demonstrate that the perception of ads                                   organizations involved in developing
                                                  differs when viewed alone or with                                                                                                         objective than participant self-reports
                                                                                                                           DTC drug communications may be                                   (Ref. 3). Also, measures taken from these
                                                  someone else. Regulating companion                                       encouraged to remain aware of the
                                                  versus solitary viewing practices would                                                                                                   spousal communications are linked
                                                                                                                           social context in which DTC ads are                              with important real world outcomes
                                                  present insurmountable legal and
                                                                                                                           often viewed and the influence of this                           including health behavior and well-
                                                  practical hurdles. Rather than conduct
                                                                                                                           context on consumer perceptions,                                 being (Ref. 4, Ref. 5), divorce, and
                                                  this study, we suggest that FDA
                                                                                                                           judgments, and decisions. Consideration                          marital satisfaction (Ref. 6, Ref. 2). This
                                                  resources and tax payer dollars would
                                                                                                                           of this broader context may facilitate the                       research method compels a discussion
                                                  be better directed to research that
                                                                                                                           development of better DTC drug                                   between partners as a way to
                                                  enhances the quality of how we
                                                                                                                           communications that remain accurate                              understand the content and style of
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                                                  communicate benefit and risk
                                                                                                                           and balanced regardless of setting.                              their communication. Thus, our
                                                  information to consumers regardless of
                                                  the setting in which the ad is viewed.                                      (Comment from Eli Lilly) Compelling                           proposed study is in keeping with the
                                                     (Response) Much research in the                                       a discussion between the consumer and                            methods in this research area.
                                                  social sciences demonstrates the strong                                  spouse about the advertisement is likely                           (Comment from Eli Lilly) We are
                                                  influence of environmental and social                                    to generate data that may or may not be                          challenged to understand how this
                                                  conditions under which humans think                                      applicable in a real-world setting.                              research yields any useful, actionable
                                                  and act. In regard to prescription drug                                  Consider removing the prescribed                                 information when it is impractical to


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                                                                                            Federal Register / Vol. 80, No. 100 / Tuesday, May 26, 2015 / Notices                                                                                                  30079

                                                  influence who is watching TV                                               We also tested an alternative version of                                        (Response) In our cognitive
                                                  advertisements at any given time.                                          this question that conforms to the                                           interviews, some participants had
                                                     (Response) As stated in response to a                                   reviewer’s re-phrasing, ‘‘In your                                            difficulty understanding the meaning of
                                                  previous comment, it is important to                                       opinion, how serious are the side effects                                    the introductory phrase ‘‘In these
                                                  generate insight about not only the                                        of [Drug X]?’’ Many cognitive interview                                      thoughts’’. Due to the ambiguity of Q20
                                                  message portrayed in DTC TV ads but                                        participants preferred this alternative                                      as a whole, we will remove this item
                                                  also the conditions under which these                                      version, and we will adopt it for the                                        from the questionnaire.
                                                  messages are received and processed.                                       final questionnaire.                                                            (Comment from Eli Lilly) Q21
                                                  Such insight may facilitate the                                               (Comment from Eli Lilly) Response                                         instructions could bias respondents to
                                                  development of better DTC drug                                             options in Q16 may be interpreted                                            evaluate each statement as risk-related.
                                                  communications regardless of setting.                                      qualitatively (i.e., on the whole, the                                       Consider rephrasing to, ‘‘The following
                                                     (Comment from Eli Lilly) Include a                                      risks outweigh the benefits) or literally                                    statements describe how people deal
                                                  ‘‘General Population’’ control group.                                      (i.e., how many more risks were stated                                       with various situations.’’
                                                     (Response) Researching each medical                                     than benefits). Rephrasing to reflect true                                      (Response) The Q21 battery is a
                                                  condition, or general population                                           intent is recommended.                                                       validated scale specifically designed to
                                                  sample, requires significant resources.                                       (Response) We appreciate this                                             measure attitudes toward risk (Ref. 7).
                                                  We are interested in response to the ads                                   comment. This item was tested in a                                           Respondents are meant to evaluate the
                                                  among consumers for whom the ad is                                         rigorous cognitive interview protocol                                        statements as though they are risk-
                                                  personally relevant (i.e., they or their                                   and there was no indication that                                             related. Therefore, we will retain the
                                                  partner have been diagnosed with                                           participants had difficulty interpreting                                     Q21 battery.
                                                  asthma). We are committed to                                               the response options. However, we will
                                                                                                                                                                                                             (Comment from Eli Lilly) The scale
                                                  conducting this research using our                                         also be conducting pretesting which
                                                                                                                                                                                                          for Q25 should be made consistent with
                                                  available resources while ensuring the                                     will provide an additional opportunity
                                                                                                                                                                                                          other scales to ensure internal
                                                  integrity of the research by collecting                                    to identify and remove questions that do
                                                                                                                                                                                                          consistency. A scale with a midpoint is
                                                  data on a high prevalence condition for                                    not function as intended, further
                                                                                                                                                                                                          recommended.
                                                  which participants might be thought of                                     refining the questionnaire prior to the
                                                  as sufficiently representative of the                                      main study.                                                                     (Response) When developing the
                                                  average consumer, thus allowing us to                                         (Comment from Eli Lilly) Q19b is                                          questionnaires, we included a number
                                                  draw conclusions about broad                                               ambiguous and unclear. Rephrasing or                                         of questions from existing multi-items
                                                  perceptual and cognitive processing                                        deletion is recommended.                                                     scales. The number and format of
                                                  outcomes.                                                                     (Response) We tested this item as part                                    response options differed from scale to
                                                     (Comment from Eli Lilly) Q12 invites                                    of our cognitive interview protocol. The                                     scale (e.g., 6-points vs. 10-points, fully
                                                  speculation from respondents who may                                       majority of participants understood this                                     labelled vs. anchors-only, etc.). We will
                                                  be unable to evaluate what is or is not                                    question, and their answers suggest that                                     revise the Likert-type response scales so
                                                  a ‘‘serious’’ side effect. Consider                                        the question did a good job of                                               that the number of levels and labeling
                                                  eliminating this question or re-phrasing                                   distinguishing between those who                                             formats across questions is consistent.
                                                  to: ‘‘Please rate the seriousness of the                                   focused on the arguments and facts                                              To examine differences between
                                                  side effects for [Drug X] that you                                         presented in the ad versus those who                                         experimental conditions, we will
                                                  remember from the ad.’’                                                    paid more attention to peripheral cues,                                      conduct inferential statistical tests such
                                                     (Response) We have conducted                                            such as the visual narrative. Because the                                    as analysis of variance. With the sample
                                                  cognitive interviews to refine and                                         item functioned as intended, we intend                                       size described in Table 3, we will have
                                                  improve the survey questions. Through                                      to retain Q19b.                                                              sufficient power to detect small-to-
                                                  this process, we found that a number of                                       (Comment from Eli Lilly) Q20 is                                           medium sized effects in the main study.
                                                  participants had difficulty reading and/                                   ambiguous and unclear. Rephrasing or                                            FDA estimates the burden of this
                                                  or answering Q12 in its original form.                                     deletion is recommended.                                                     collection of information as follows:

                                                                                                                 TABLE 3—ESTIMATED ANNUAL REPORTING BURDEN 1
                                                                                                                                                                                   Number of
                                                                                                                                                             Number of              responses             Total annual            Average burden
                                                                                              Activity                                                                                                                                                          Total hours
                                                                                                                                                            respondents                per                 responses               per response
                                                                                                                                                                                   respondent

                                                                                                                                                           Pretesting

                                                  Number to Complete the Screener .................................................                                       700                        1                 700       0.08 (5 minutes)                       56
                                                  Number of Completes .....................................................................                               120                        1                 120       1 .........................           120

                                                                                                                                                           Main Study

                                                  Number to Complete the Screener .................................................                                    4,060                         1               4,060       0.08 (5 minutes)                      325
                                                  Number of Completes .....................................................................                              792                         1                 792       1 .........................           792
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                                                        Total ..........................................................................................    ....................   ....................   ....................   ............................         1,293
                                                     1 There    are no capital costs or operating and maintenance costs associated with this collection of information.


                                                  References                                                                 Management (see ADDRESSES) and may be                                        www.regulations.gov. (FDA has verified all
                                                    The following references have been placed                                seen by interested persons between 9 a.m.                                    the Web site addresses in this reference
                                                                                                                             and 4 p.m., Monday through Friday, and are                                   section, but we are not responsible for any
                                                  on display in the Division of Dockets
                                                                                                                             available electronically at http://



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                                                  30080                          Federal Register / Vol. 80, No. 100 / Tuesday, May 26, 2015 / Notices

                                                  subsequent changes to the Web sites after this          examination. Based on an annual                       individuals associated with the grant
                                                  document publishes in the Federal Register.)            objective review of the qualifications                applications, the disclosure of which
                                                  Reis, H., and C. Judd, Handbook of Research             and content of the examination, the                   would constitute a clearly unwarranted
                                                      Methods in Social and Personality                   Secretary shall annually publish a list in            invasion of personal privacy.
                                                      Psychology, 2nd Ed. New York:                       the Federal Register of those entities
                                                      Cambridge University Press (2014).                                                                          Name of Committee: National Institute of
                                                  Kerig, P.K., and D.H. Baucom, (Eds.). Couple
                                                                                                          and boards that have been approved.’’                 General Medical Sciences Initial Review
                                                      Observational Coding Systems, Mahwah,                 HHS has completed its review of                     Group; Training and Workforce Development
                                                      NJ: Erlbaum (2004).                                 entities that certify MROs, in                        Subcommittee—C.
                                                  Bakeman, R., Behavioral Observation and                 accordance with requests submitted by                   Date: June 8, 2015.
                                                      Coding, In H.T. Reis & C.M. Judd (Eds.)             such entities to HHS.                                   Time: 8:30 a.m. to 5:00 p.m.
                                                      Handbook of Research Methods in Social                The HHS Secretary approves the                        Agenda: To review and evaluate grant
                                                      and Personality Psychology,pp. 138–159.             following MRO certifying entities that                applications.
                                                      New York: Cambridge University Press                                                                        Place: Hotel Monaco Alexandria, 480 King
                                                                                                          offer MRO certification through                       Street, Alexandria, VA 22314.
                                                      (2000).
                                                                                                          examination:                                            Contact Person: Mona R. Trempe, Ph.D.,
                                                  Ewart, C.K., C.B. Taylor, H.C. Kraemer, and
                                                      W.S. Agras. ‘‘High Blood Pressure and               American Association of Medical                       Scientific Review Officer, Office of Scientific
                                                      Marital Discord: Not Being Nasty Matters              Review Officers (AAMRO), P.O. Box                   Review, National Institute of General Medical
                                                      More Than Being Nice,’’ Health                        12873, Research Triangle Park, NC                   Sciences, National Institutes of Health, 45
                                                      Psychology, 10, pp. 155–163 (1991).                   27709; Phone: (800) 489–1839; Fax:                  Center Drive, Room 3An.12A, Bethesda, MD
                                                  Spitzberg, B.H., and W.R. Cupach, Handbook                (919) 490–1010; Email: cferrell@                    20892–4874, 301–594–3998, trempemo@
                                                      of Interpersonal Competence Research,                                                                     mail.nih.gov.
                                                                                                            aamro.com; Web site: http://
                                                      NY: Springer-Verlag (1989).                                                                                 This notice is being published less than 15
                                                  Gottman, J.M., What Predicts Divorce? The
                                                                                                            www.aamro.com/.                                     days prior to the meeting due to the timing
                                                      Relationship Between Marital Processes              Medical Review Officer Certification                  limitations imposed by the review and
                                                      and Marital Outcomes. Hillsdale, NJ:                  Council (MROCC), 836 Arlington                      funding cycle.
                                                      Erlbaum (1994).                                       Heights Road, #327, Elk Grove
                                                                                                                                                                (Catalogue of Federal Domestic Assistance
                                                  Rohrmann, B., ‘‘Risk Attitude Scales:                     Village, IL 60007; Phone: (847) 631–                Program Nos. 93.375, Minority Biomedical
                                                      Concepts, Questionnaires, Utilizations                0599; Fax: (847) 483–1282; Email:                   Research Support; 93.821, Cell Biology and
                                                      [Project Report],’’ University of                     mrocc@mrocc.org; Web site: http://                  Biophysics Research; 93.859, Pharmacology,
                                                      Melbourne, Australia. Retrieved from                  www.mrocc.org/.                                     Physiology, and Biological Chemistry
                                                      http://www.rohrmannresearch.net/pdfs/                                                                     Research; 93.862, Genetics and
                                                      rohrmann-racreport.pdf (2005).                      DATES: HHS approval is effective May
                                                                                                          26, 2015.                                             Developmental Biology Research; 93.88,
                                                    Dated: May 18, 2015.                                                                                        Minority Access to Research Careers; 93.96,
                                                                                                          FOR FURTHER INFORMATION CONTACT:                      Special Minority Initiatives, National
                                                  Leslie Kux,
                                                                                                          Jennifer Fan, Pharm.D., J.D., Division of             Institutes of Health, HHS)
                                                  Associate Commissioner for Policy.                      Workplace Programs (DWP), Center for
                                                  [FR Doc. 2015–12582 Filed 5–22–15; 8:45 am]                                                                     Dated: May 19, 2015.
                                                                                                          Substance Abuse Prevention (CSAP),
                                                  BILLING CODE 4164–01–P                                  Substance Abuse and Mental Health                     Melanie J. Gray,
                                                                                                          Services Administration (SAMHSA), 1                   Program Analyst, Office of Federal Advisory
                                                                                                          Choke Cherry Road, Room 7–1038,                       Committee Policy.
                                                  DEPARTMENT OF HEALTH AND                                Rockville, MD 20857; Telephone: (240)                 [FR Doc. 2015–12543 Filed 5–22–15; 8:45 am]
                                                  HUMAN SERVICES                                          276–1759; Email: jennifer.fan@                        BILLING CODE 4140–01–P
                                                                                                          samhsa.hhs.gov
                                                  Mandatory Guidelines for Federal
                                                  Workplace Drug Testing Programs                           Dated: May 15, 2015.                                DEPARTMENT OF HEALTH AND
                                                                                                          Sylvia M. Burwell,                                    HUMAN SERVICES
                                                  AGENCY:  Substance Abuse and Mental
                                                                                                          Secretary.
                                                  Health Services Administration                                                                                National Institutes of Health
                                                                                                          [FR Doc. 2015–12559 Filed 5–22–15; 8:45 am]
                                                  (SAMHSA), Department of Health and
                                                                                                          BILLING CODE 4160–20–P
                                                  Human Services.                                                                                               Prospective Grant of Exclusive
                                                  ACTION: HHS Approval of Entities That                                                                         License: Development of Autologous
                                                  Certify Medical Review Officers (MRO).                  DEPARTMENT OF HEALTH AND                              Tumor Infiltrating Lymphocyte
                                                                                                          HUMAN SERVICES                                        Adoptive Cells for the Treatment of
                                                  SUMMARY:   The current version of the                                                                         Lung, Breast, Bladder, and HPV-
                                                  Department of Health and Human                                                                                Positive Cancers
                                                                                                          National Institutes of Health
                                                  Services (HHS) Mandatory Guidelines
                                                  for Federal Workplace Drug Testing                      National Institute of General Medical                 AGENCY:   National Institutes of Health,
                                                  Programs (Mandatory Guidelines),                        Sciences; Notice of Closed Meeting                    HHS.
                                                  effective on October 1, 2010, addresses                                                                       ACTION:   Notice.
                                                  the role and qualifications of Medical                    Pursuant to section 10(d) of the
                                                  Review Officers (MROs) and HHS                          Federal Advisory Committee Act, as                    SUMMARY:   This is notice, in accordance
                                                  approval of entities that certify MROs.                 amended (5 U.S.C. App.), notice is                    with 35 U.S.C. 209 and 37 CFR 404, that
                                                     Subpart M—Medical Review Officer                     hereby given of the following meeting.                the National Institutes of Health,
                                                  (MRO), Section 13.1(b) of the Mandatory                   The meeting will be closed to the                   Department of Health and Human
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  Guidelines, ‘‘Who may serve as an                       public in accordance with the                         Services, is contemplating the grant of
                                                  MRO?’’ states as follows: ‘‘Nationally                  provisions set forth in sections                      an exclusive patent license to the
                                                  recognized entities that certify MROs or                552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,            current licensee, Lion Biotechnologies,
                                                  subspecialty boards for physicians                      as amended. The grant applications and                Inc., which is located in Woodland
                                                  performing a review of Federal                          the discussions could disclose                        Hills, California to practice the
                                                  employee drug test results that seek                    confidential trade secrets or commercial              inventions embodied in the following
                                                  approval by the Secretary must submit                   property such as patentable material,                 patent applications and applications
                                                  their qualifications and a sample                       and personal information concerning                   claiming priority to these applications:


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Document Created: 2018-02-21 10:31:12
Document Modified: 2018-02-21 10:31:12
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesFax written comments on the collection of information by June 25, 2015.
ContactFDA PRA Staff, Office of Operations, Food and Drug Administration, 8455 Colesville Rd., COLE-14526, Silver Spring, MD 20993-0002, [email protected]
FR Citation80 FR 30077 

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