83_FR_26399 83 FR 26290 - Criteria for Evidence of Effectiveness To Be Applied to Projects Identified for Inclusion in the What Works Clearinghouse of Proven and Promising Projects To Move Welfare Recipients Into Work

83 FR 26290 - Criteria for Evidence of Effectiveness To Be Applied to Projects Identified for Inclusion in the What Works Clearinghouse of Proven and Promising Projects To Move Welfare Recipients Into Work

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families

Federal Register Volume 83, Issue 109 (June 6, 2018)

Page Range26290-26293
FR Document2018-12160

The Administration for Children and Families, HHS, solicits comments by August 5, 2018 on the criteria for evidence of effectiveness for the What Works Clearinghouse of Proven and Promising Projects to Move Welfare Recipients into Work. Final criteria for evidence of effectiveness will be used to develop the clearinghouse.

Federal Register, Volume 83 Issue 109 (Wednesday, June 6, 2018)
[Federal Register Volume 83, Number 109 (Wednesday, June 6, 2018)]
[Notices]
[Pages 26290-26293]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-12160]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Criteria for Evidence of Effectiveness To Be Applied to Projects 
Identified for Inclusion in the What Works Clearinghouse of Proven and 
Promising Projects To Move Welfare Recipients Into Work

AGENCY: Administration for Children and Families (ACF), U.S. Department 
of Health and Human Services (HHS).

ACTION: Request for public comment.

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

SUMMARY: The Administration for Children and Families, HHS, solicits 
comments by August 5, 2018 on the criteria for evidence of 
effectiveness for the What Works Clearinghouse of Proven and Promising 
Projects to Move Welfare Recipients into Work. Final criteria for 
evidence of effectiveness will be used to develop the clearinghouse.

SUPPLEMENTARY INFORMATION: 
    Invitation to Comment: HHS invites comments regarding this notice 
on the proposed criteria for HHS's systematic review of the evidence. 
To ensure that your comments are clearly stated, please identify the 
specific criterion or other section of this notice that your comments 
address.

1.0 Background

1.1 Legislative Context

    The Consolidated Appropriations Act of 2017 (Pub. L. 115-31 
(https://www.congress.gov/115/plaws/publ31/PLAW-115publ31.pdf)) directs 
the U.S. Department of Health and Human Services (HHS) to create a 
database of projects that have used a proven or promising approach to 
move welfare recipients into work, based on independent, rigorous 
evaluations of the projects, and to create a What Works Clearinghouse 
of Proven and Promising Projects to Move Welfare Recipients into Work. 
As stated in the statute, the database shall additionally ``include a 
separate listing of projects that used a developmental approach in 
delivering services and a further separate listing of the projects with 
no or negative effects.'' The statute requires HHS to establish 
criteria for evidence of effectiveness.

1.2 The Legislation's Direction for Establishing the Criteria for 
Evidence of Effectiveness

    Section 413(g)(2) of Public Law 115-31 charges the Secretary of 
Health and Human Services with establishing the criteria of 
effectiveness. The statute further stipulated that the (B) process for 
establishing the criteria--
    (i) is transparent;
    (ii) is consistent across agencies;
    (iii) provides opportunity for public comment; and
    (iv) takes into account efforts of Federal agencies to identify and 
publicize effective interventions, including efforts at the Department 
of Health and Human Services, the Department of Education, and the 
Department of Justice.

1.3 The Employment Strategies for Low-Income Adults Evidence Review

    Prior to the enactment of Public Law 115-31, the Office of 
Planning, Research, and Evaluation (OPRE) at the Administration for 
Children and Families (ACF) at HHS had developed the Employment 
Strategies for Low-Income Adults Evidence Review (ESER). The new 
statute aligns with and extends the work of ESER. HHS proposes building 
on this existing work to develop the new Clearinghouse.
    The Employment Strategies for Low-Income Adults Evidence Review 
(ESER) is a systematic review of the evaluation research published 
between 1990 and 2014 on employment and training programs for low-
income adults. It culminated in a searchable, public database (https://employmentstrategies.acf.hhs.gov/). The review was supplemented with 
briefs synthesizing the results of the review and highlighting 
strategies that appeared to be promising, as identified by the review. 
To identify the programs and strategies--or interventions-- that appear 
to be most effective in helping low-income adults gain and retain 
employment, ESER systematically identified, assessed, and synthesized 
evidence from the existing evaluation research literature. A core 
component of ESER's review, as with other federal evidence reviews, 
involved assessing the quality of the research evidence on different 
interventions.
    To assess the quality of the evidence, ESER reviewed each study's 
methods to

[[Page 26291]]

determine if they were rigorous enough to ensure that the study's 
findings could be considered reliable. ESER assessed whether the 
study's methods reliably supported the conclusion that an 
intervention's impacts were caused by the intervention and not by 
something else. The standards for assessing studies' methods were 
defined based on consultation with federal experts on evidence reviews 
and researchers with expertise in evaluation methodology. To 
differentiate among different levels of the strength of evidence, ESER 
assigned a High, Moderate, or Low rating to each study reviewed. 246 of 
the 314 studies included in the review earned a High rating and 1 study 
earned a Moderate rating. The remaining 67 studies received a Low 
rating.
    Through this review, ESER was able to identify interventions whose 
findings could be considered most reliable. Studies' ratings reflect 
the rigor of their study methods, independent of whether the findings 
were positive or negative. As a result, a study could be rated High or 
Moderate even if the intervention studied did not improve the outcomes 
for low-income adults. While the vast majority of studies included in 
ESER achieved a High rating (and, therefore, are considered to provide 
reliable, or strong, evidence), the review also found that, overall, 
null impacts were more prevalent than statistically significant 
impacts.
    While ESER did not assess the effectiveness of the interventions 
reviewed, ESER conducted a number of preliminary steps necessary for 
assessing effectiveness. This included categorizing each study's 
findings according to whether it found positive, negative or null 
impacts for the interventions studied. In addition, through a number of 
synthesis briefs (published on the website), ESER qualitatively and 
quantitatively summarized the direction of impacts for different 
interventions and highlighted interventions associated with the 
greatest number of positive impacts.
    To be included in ESER, studies had to--
     Quantitatively measure the effectiveness of a program or 
strategy
     Be published between 1990 and 2014
     Study an employment program or strategy-- an 
intervention-- that
    [cir] had a primary aim of improving employment-related outcomes
    [cir] primarily targeted low-income adults
    [cir] took place in the United States, Canada, or the United 
Kingdom
    To identify studies eligible for review, ESER issued a call for 
papers, conducted literature searches, and consulted with experts in 
workforce development programs that serve low-income adults.
    ESER looked at the effects of the interventions on four domains, or 
outcome areas:
     Employment
     Earnings
     Public benefit receipt
     Education/training
    Outcomes were examined for short and longer-term impacts (longer-
term was measured as being more than 18 months after the intervention 
was implemented).
    The ESER website (https://employmentstrategies.acf.hhs.gov/) 
reports key results for all eligible studies. The website also allows 
users to search for results by program studied, target population, 
outcome(s) of interest, service strategies, intervention setting, year 
of study publication, and whether favorable impacts were found.
    While ESER's overall population of interest was low-income adults, 
a majority of the studies in ESER examined welfare populations. Because 
studies of interventions in a welfare setting typically include both 
recipients and applicants, ESER does not include any studies that 
solely focused on welfare recipients. ESER does, however, include 
interventions targeted to low-income populations understood to share 
important characteristics with welfare recipients, such as other public 
benefit recipients, and those considered hard to employ, including 
those who have been homeless or formerly incarcerated.

2.0 Process for Establishing the Criteria of Effectiveness for the New 
What Works Clearinghouse

    In fall 2017 and early winter 2018, OPRE engaged in a series of 
systematic consultations with federal and non-federal technical experts 
on evidence reviews. In addition to representation from the Department 
of Labor (DOL) and the Department of Education (ED) in these 
consultations, federal representation included the Department of 
Justice (DOJ) and a number of HHS agencies/offices including the Office 
of Family Assistance (OFA), the Office of Planning, Research, and 
Evaluation (OPRE), the Office of the Assistant Secretary for Planning 
and Evaluation (ASPE) and the Agency for Healthcare Research and 
Quality (AHRQ).
    The objective of these consultations was to help HHS:
    (1) Develop criteria for categorizing interventions in the new 
Clearinghouse as proven, promising, developmental, or ineffective,
    (2) develop these criteria through a process that
    a. involved consultation with the Department of Labor (DOL), the 
Department of Education (ED), and other entities with experience 
evaluating relevant effectiveness research,
    b. allowed HHS to better understand other Federal evidence reviews' 
standards and processes and determine where it would make sense for the 
new Clearinghouse to be consistent with these standards and processes, 
and
    (3) learn best practices from other Federal evidence reviews for 
identifying and publicizing effective interventions

2.1 Transparent

    To ensure that the Clearinghouse's procedures and standards, 
including the criteria for evidence of effectiveness, are transparent, 
HHS intends to implement the following practices:
     Post the procedures and standards and information about 
the process on the Clearinghouse website.
     Provide the public a means of contacting the 
Clearinghouse, for example, by establishing a help desk to respond to 
email inquiries.

2.2 Consistent Across Agencies

    To ensure that the Clearinghouse is as consistent as possible with 
other federal evidence reviews in its processes and standards, HHS 
intends to implement the following practices:
     Adopt the standards and methods for reviewing studies from 
OPRE's existing Employment Strategies Evidence Review (ESER) (https://www.acf.hhs.gov/opre/resource/employment-strategies-for-low-income-adults-evidence-review-standards-and-methods), which are broadly 
consistent with other federal Clearinghouses. ESER's standards and 
methods (e.g., author queries; number and training of reviewers; 
choices about reporting effect sizes) were developed by considering 
both the choices made by other federal and non-federal Clearinghouses 
and the standards of research in the employment and training 
intervention field. Other existing federal Clearinghouses have followed 
this same approach (considering both the choices made by other 
clearinghouses and the norms of research within their fields of focus).
     In any instances where the new Clearinghouse's ratings of 
a project's strength of evidence or effectiveness differ from another 
federal evidence review that rates projects according to the same 
outcomes (such as the Department of Labor's (DOL's) Clearinghouse for 
Labor Evaluation and

[[Page 26292]]

Research (CLEAR)), annotate the findings to explain the reason for the 
difference.

2.3 Provides Opportunity for Public Comment

    To provide an opportunity for public comment on the criteria for 
effectiveness, ACF is publishing this Federal Register Notice.

2.4 Takes Into Account Efforts of Federal Agencies To Identify and 
Publicize Effective Interventions

    To ensure the Clearinghouse reflects the learning of other Federal 
agencies about how to identify and publicize effective interventions, 
HHS intends to implement the following practices:
     Use some of the methods adopted by other clearinghouses to 
create multiple products tailored to different audiences and use 
graphic design and other user-friendly dissemination elements to help 
users digest evidence quickly.
     Include information on the Clearinghouse website that is 
especially useful to practitioners, such as summary information about 
projects and approaches.
     Develop and incorporate alternative media for the 
Clearinghouse such as videos that will tailor communication to various 
groups.
     Ensure that information is effectively conveyed on the 
Clearinghouse website by soliciting feedback from various stakeholders 
who can represent key target audiences. Key among these would be state 
or county Temporary Assistance for Needy Families (TANF) and Workforce 
Development practitioners, as well as evaluation researchers.

3.0 Proposed Criteria for Evidence of Effectiveness

3.1 Criteria for Well-Designed, Rigorous Impact Research

    HHS intends to employ the criteria established by OPRE's Employment 
Strategies for Low-Income Adults Evidence Review (ESER) to assess the 
quality of study design and to assess the strength of the evidence 
resulting from studies. These criteria (referred to as ``standards and 
methods'') are available in ESER's Standards and Methods report https://www.acf.hhs.gov/opre/resource/employment-strategies-for-low-income-adults-evidence-review-standards-and-methods.

3.2 Proposed Criteria for Evidence of Effectiveness for Projects 
Included in the Clearinghouse

3.2.1 Definition of Project and Approach
    The legislation requires that ratings, or categorizations, of 
evidence of effectiveness be applied to projects and approaches. To 
standardize definitions for these terms, HHS intends to define a 
project and an approach as follows:
     Define project to be a specific bundle of services and/or 
policies implemented in a given context.
     Project will be the unit that receives an effectiveness 
rating (i.e. proven, promising, developmental, or ineffective).
     Define approach to be the guiding framework of specific 
services (e.g., career pathways).
     Approaches will not be rated as proven, promising, 
developmental, or ineffective, but the Clearinghouse will include 
narrative summaries related to different approaches.
     While the legislation does not require HHS to define or 
evaluate the effectiveness of program components, there is interest in 
the field in examining program components. Thus, HHS intends that the 
Clearinghouse include meta-analyses of specific components of projects 
(such as ``case management'' or ``job search assistance'') whenever 
appropriate and feasible.
3.2.2 Parameters Guiding the Application of Evidence of Effectiveness 
Ratings
    Before a project can be categorized as being proven, promising, 
developmental, or ineffective, a number of preliminary definitions, or 
parameters, must be established to guide decision making. These include 
the outcomes for which a project's effectiveness will be evaluated, how 
a favorable or unfavorable effect will be measured, and how an 
effectiveness rating will be applied to a project.
3.2.2.1 Outcomes
    HHS intends that the new Clearinghouse will review the following 
outcomes:
    [cir] Employment (short and longer-term),
    [cir] earnings (short and longer-term),
    [cir] educational attainment, and
    [cir] public benefit receipt.
3.2.2.2 Definition of Favorable and Unfavorable Effects
    HHS intends that the Clearinghouse consider only statistically 
significant findings (p <.05) as evidence of favorable or unfavorable 
effects.
3.2.2.3 Pre-Defining Criteria for Selecting Among Multiple Outcome 
Measures
    HHS intends to reduce the likelihood for reporting a false positive 
rate for outcomes--an issue that can occur when studies use multiple 
measures or multiple outcomes to assess impacts in the same domain 
(e.g., short-term earnings)--by relying on the decision rules ESER 
developed to address the potential for multiple comparisons. https://www.acf.hhs.gov/opre/resource/employment-strategies-for-low-income-adults-evidence-review-standards-and-methods).
3.2.2.4 Application of Evidence of Effectiveness Ratings
    HHS intends that evidence of effectiveness ratings will be applied 
within outcome domains; each project will receive ratings of 
effectiveness on each outcome domain (e.g., a project may be found 
promising for short-term employment but ineffective for long-term 
employment). There will be no overall rating for the project.
3.2.3 Definition of Proven
    The legislation directs HHS to categorize projects as Proven, 
Promising, Developmental, or Ineffective.
    HHS intends that for a project to be considered proven, the 
following conditions must be met:
     There must be at least two separate studies of the same 
project that meet evidence standards and meet criteria for a promising 
rating.
    [cir] Studies are considered to be separate studies of the same 
project if they use non-overlapping samples to examine distinct 
implementations of the project.
     There must be only favorable or null impacts within a 
given outcome domain. Thus, no studies that meet evidence standards for 
a given outcome domain can show an unfavorable impact within that 
domain.
     Projects that have both favorable and unfavorable impacts 
in a given domain will be categorized as mixed.
     A project has a limited number, or proportion, of null 
findings in a given domain.
    HHS is soliciting comments on how to best determine the ceiling for 
the number, or proportion, of null to positive findings in a given 
domain.
    If subsequent studies or replications result in only null findings 
in a given domain, the review will establish procedures for revisiting 
a project's rating of proven.

[[Page 26293]]

3.2.4 Definition of Promising
    HHS intends that for a project to be considered promising, the 
following conditions must be met:
     One study of a project must meet evidence standards.
     That study must find only favorable or null impacts within 
a given outcome domain. Thus no studies that meet evidence standards 
for an outcome domain can show an unfavorable impact within the domain.
    [cir] If the review examines more than one measure to identify 
impacts on a particular domain (e.g., Unemployment Insurance data and 
participant survey data), as long as one measure (among those selected 
according to 3.2.2.3 above) finds favorable impacts for that outcome, 
the intervention can receive a Promising rating for that outcome.
     Projects that have both favorable and unfavorable impacts 
in a given domain will be categorized as mixed.
3.2.5 Definition of Ineffective
    HHS intends that for a project to be considered ineffective, the 
following conditions must be met:
     One or more studies of a project must meet evidence 
standards.
     There must be only findings of unfavorable or null effects 
in a given domain.
     For studies finding null effect in a given domain, the 
review will include a measure of statistical precision--so that small, 
under-powered studies do not drive the effectiveness rating. If an 
intervention has been evaluated using only small studies, a lack of 
detectable effects could reflect either ineffectiveness of the 
intervention or the lack of statistical power to detect effects. It 
would be misleading to characterize this latter scenario as an 
ineffective project.
3.2.6 Definition of Developmental
    HHS intends that for a project to be considered developmental, the 
following conditions must be met:
     There must be at least one current, ongoing evaluation of 
the project that uses a study design that meets evidence standards but 
has not yet produced impact findings.
3.2.7 Additional Category of Mixed and Definition of Mixed
    HHS intends that there be an additional category for categorizing 
evidence of effectiveness called mixed. HHS proposes that for a project 
to be considered mixed, the following conditions must be met:
     One or more studies of a project must meet evidence 
standards.
     The studies find both favorable and unfavorable impact 
estimates within the same domain.
    3.2.8 HHS intends that narrative descriptions of rated projects, 
narrative descriptions of approaches, and information on case studies 
be provided to users of the Clearinghouse to facilitate a fuller 
understanding of the field of welfare-to-work interventions.

4.0 Submission of Comments

    Comments may be submitted until August 5, 2018 by email to 
[email protected].

Naomi Goldstein,
Deputy Assistant Secretary for Planning, Research, and Evaluation.
[FR Doc. 2018-12160 Filed 6-5-18; 8:45 am]
 BILLING CODE 4184-09-P



                                               26290                                 Federal Register / Vol. 83, No. 109 / Wednesday, June 6, 2018 / Notices

                                               the Act Against AIDS National Testing’’.                                 Depending on the target audience for                                           Respondents will be recruited through
                                               The information collected from these                                     the campaign phase, the study screener                                       national opt-in email lists, the internet,
                                               data collections was used to evaluate a                                  will vary. The study screener may                                            and external partnerships with
                                               specific AAA campaign phase. We are                                      address one or more of the following                                         community-based and membership
                                               requesting the same amount of time to                                    items: Race/ethnicity, sexual behavior,                                      organizations that work with or
                                               continue surveying AAA target                                            sexual orientation, gender identity, HIV                                     represent individuals from targeted
                                               audiences as new phases are developed.                                   testing history, HIV status, and injection                                   populations (e.g., National Urban
                                                 Through this extension, we plan to                                     drug use. Each survey will have a core                                       League, the National Medical
                                               reach the remaining approved 6,445                                       set of items asked in all rounds, as well                                    Association). Respondents will self-
                                               respondents. To obtain the remaining                                     as a module of questions relating to                                         administer the survey at home on
                                               respondents, we anticipate screening                                     specific AAA phases and activities.                                          personal computers. There is no cost to
                                               approximately 32,220 individuals.                                                                                                                     the respondents other than their time.
                                                                                                                       ESTIMATED ANNUALIZED BURDEN HOURS
                                                                                                                                                                                                                                 Average
                                                                                                                                                                                                   Number of                                              Total
                                                                                                                                                                        Number of                                              burden per
                                                                   Type of respondents                                                Form name                                                  responses per                                           burden
                                                                                                                                                                       respondents                                              response
                                                                                                                                                                                                   respondent                                          (in hours)
                                                                                                                                                                                                                                (in hours)

                                               Individuals (male and female) aged 18 years and                              Study Screener .............                           10,740                             1                     2/60                358
                                                 older.                                                                     Survey ..........................                       2,148                             1                    30/60              1,074

                                                    Total ...............................................................   .......................................   ........................   ........................   ........................          1,432



                                               Jeffrey M. Zirger,                                                       section of this notice that your                                             Health and Human Services, the
                                               Acting Chief, Information Collection Review                              comments address.                                                            Department of Education, and the
                                               Office, Office of Scientific Integrity, Office                                                                                                        Department of Justice.
                                               of the Associate Director for Science, Office                            1.0 Background
                                               of the Director, Centers for Disease Control                                                                                                          1.3 The Employment Strategies for Low-
                                                                                                                        1.1 Legislative Context
                                               and Prevention.                                                                                                                                       Income Adults Evidence Review
                                                                                                                          The Consolidated Appropriations Act
                                               [FR Doc. 2018–12082 Filed 6–5–18; 8:45 am]                                                                                                               Prior to the enactment of Public Law
                                                                                                                        of 2017 (Pub. L. 115–31 (https://
                                               BILLING CODE 4163–18–P                                                                                                                                115–31, the Office of Planning,
                                                                                                                        www.congress.gov/115/plaws/publ31/
                                                                                                                                                                                                     Research, and Evaluation (OPRE) at the
                                                                                                                        PLAW-115publ31.pdf)) directs the U.S.
                                                                                                                                                                                                     Administration for Children and
                                               DEPARTMENT OF HEALTH AND                                                 Department of Health and Human
                                                                                                                                                                                                     Families (ACF) at HHS had developed
                                               HUMAN SERVICES                                                           Services (HHS) to create a database of
                                                                                                                                                                                                     the Employment Strategies for Low-
                                                                                                                        projects that have used a proven or
                                                                                                                                                                                                     Income Adults Evidence Review (ESER).
                                               Administration for Children and                                          promising approach to move welfare
                                                                                                                                                                                                     The new statute aligns with and extends
                                               Families                                                                 recipients into work, based on
                                                                                                                                                                                                     the work of ESER. HHS proposes
                                                                                                                        independent, rigorous evaluations of the
                                                                                                                                                                                                     building on this existing work to
                                               Criteria for Evidence of Effectiveness                                   projects, and to create a What Works
                                                                                                                                                                                                     develop the new Clearinghouse.
                                               To Be Applied to Projects Identified for                                 Clearinghouse of Proven and Promising                                           The Employment Strategies for Low-
                                               Inclusion in the What Works                                              Projects to Move Welfare Recipients into                                     Income Adults Evidence Review (ESER)
                                               Clearinghouse of Proven and                                              Work. As stated in the statute, the                                          is a systematic review of the evaluation
                                               Promising Projects To Move Welfare                                       database shall additionally ‘‘include a                                      research published between 1990 and
                                               Recipients Into Work                                                     separate listing of projects that used a                                     2014 on employment and training
                                                                                                                        developmental approach in delivering                                         programs for low-income adults. It
                                               AGENCY:  Administration for Children                                     services and a further separate listing of
                                               and Families (ACF), U.S. Department of                                                                                                                culminated in a searchable, public
                                                                                                                        the projects with no or negative effects.’’                                  database (https://
                                               Health and Human Services (HHS).                                         The statute requires HHS to establish                                        employmentstrategies.acf.hhs.gov/). The
                                               ACTION: Request for public comment.                                      criteria for evidence of effectiveness.                                      review was supplemented with briefs
                                                                                                                        1.2 The Legislation’s Direction for                                          synthesizing the results of the review
                                               SUMMARY:    The Administration for
                                                                                                                        Establishing the Criteria for Evidence of                                    and highlighting strategies that
                                               Children and Families, HHS, solicits
                                                                                                                        Effectiveness                                                                appeared to be promising, as identified
                                               comments by August 5, 2018 on the
                                                                                                                          Section 413(g)(2) of Public Law 115–                                       by the review. To identify the programs
                                               criteria for evidence of effectiveness for
                                                                                                                        31 charges the Secretary of Health and                                       and strategies—or interventions— that
                                               the What Works Clearinghouse of
                                                                                                                        Human Services with establishing the                                         appear to be most effective in helping
                                               Proven and Promising Projects to Move
                                                                                                                        criteria of effectiveness. The statute                                       low-income adults gain and retain
                                               Welfare Recipients into Work. Final
                                                                                                                        further stipulated that the (B) process                                      employment, ESER systematically
                                               criteria for evidence of effectiveness will
                                                                                                                        for establishing the criteria—                                               identified, assessed, and synthesized
                                               be used to develop the clearinghouse.
                                                                                                                          (i) is transparent;                                                        evidence from the existing evaluation
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                                               SUPPLEMENTARY INFORMATION:                                                 (ii) is consistent across agencies;                                        research literature. A core component of
                                                 Invitation to Comment: HHS invites                                       (iii) provides opportunity for public                                      ESER’s review, as with other federal
                                               comments regarding this notice on the                                    comment; and                                                                 evidence reviews, involved assessing
                                               proposed criteria for HHS’s systematic                                     (iv) takes into account efforts of                                         the quality of the research evidence on
                                               review of the evidence. To ensure that                                   Federal agencies to identify and                                             different interventions.
                                               your comments are clearly stated, please                                 publicize effective interventions,                                              To assess the quality of the evidence,
                                               identify the specific criterion or other                                 including efforts at the Department of                                       ESER reviewed each study’s methods to


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                                                                             Federal Register / Vol. 83, No. 109 / Wednesday, June 6, 2018 / Notices                                             26291

                                               determine if they were rigorous enough                  conducted literature searches, and                       (2) develop these criteria through a
                                               to ensure that the study’s findings could               consulted with experts in workforce                    process that
                                               be considered reliable. ESER assessed                   development programs that serve low-                     a. involved consultation with the
                                               whether the study’s methods reliably                    income adults.                                         Department of Labor (DOL), the
                                               supported the conclusion that an                          ESER looked at the effects of the                    Department of Education (ED), and
                                               intervention’s impacts were caused by                   interventions on four domains, or                      other entities with experience
                                               the intervention and not by something                   outcome areas:                                         evaluating relevant effectiveness
                                               else. The standards for assessing                         • Employment                                         research,
                                               studies’ methods were defined based on                    • Earnings                                             b. allowed HHS to better understand
                                               consultation with federal experts on                      • Public benefit receipt                             other Federal evidence reviews’
                                               evidence reviews and researchers with                     • Education/training                                 standards and processes and determine
                                               expertise in evaluation methodology. To                   Outcomes were examined for short                     where it would make sense for the new
                                               differentiate among different levels of                 and longer-term impacts (longer-term                   Clearinghouse to be consistent with
                                               the strength of evidence, ESER assigned                 was measured as being more than 18                     these standards and processes, and
                                               a High, Moderate, or Low rating to each                 months after the intervention was                        (3) learn best practices from other
                                               study reviewed. 246 of the 314 studies                  implemented).                                          Federal evidence reviews for identifying
                                               included in the review earned a High                      The ESER website (https://                           and publicizing effective interventions
                                               rating and 1 study earned a Moderate                    employmentstrategies.acf.hhs.gov/)                     2.1 Transparent
                                               rating. The remaining 67 studies                        reports key results for all eligible
                                               received a Low rating.                                                                                            To ensure that the Clearinghouse’s
                                                                                                       studies. The website also allows users to              procedures and standards, including the
                                                  Through this review, ESER was able                   search for results by program studied,
                                               to identify interventions whose findings                                                                       criteria for evidence of effectiveness, are
                                                                                                       target population, outcome(s) of interest,             transparent, HHS intends to implement
                                               could be considered most reliable.                      service strategies, intervention setting,
                                               Studies’ ratings reflect the rigor of their                                                                    the following practices:
                                                                                                       year of study publication, and whether                    • Post the procedures and standards
                                               study methods, independent of whether                   favorable impacts were found.
                                               the findings were positive or negative.                                                                        and information about the process on
                                                                                                         While ESER’s overall population of                   the Clearinghouse website.
                                               As a result, a study could be rated High                interest was low-income adults, a                         • Provide the public a means of
                                               or Moderate even if the intervention                    majority of the studies in ESER                        contacting the Clearinghouse, for
                                               studied did not improve the outcomes                    examined welfare populations. Because                  example, by establishing a help desk to
                                               for low-income adults. While the vast                   studies of interventions in a welfare                  respond to email inquiries.
                                               majority of studies included in ESER                    setting typically include both recipients
                                               achieved a High rating (and, therefore,                 and applicants, ESER does not include                  2.2 Consistent Across Agencies
                                               are considered to provide reliable, or                  any studies that solely focused on                        To ensure that the Clearinghouse is as
                                               strong, evidence), the review also found                welfare recipients. ESER does, however,                consistent as possible with other federal
                                               that, overall, null impacts were more                   include interventions targeted to low-                 evidence reviews in its processes and
                                               prevalent than statistically significant                income populations understood to share                 standards, HHS intends to implement
                                               impacts.                                                important characteristics with welfare                 the following practices:
                                                  While ESER did not assess the                        recipients, such as other public benefit                  • Adopt the standards and methods
                                               effectiveness of the interventions                      recipients, and those considered hard to               for reviewing studies from OPRE’s
                                               reviewed, ESER conducted a number of                    employ, including those who have been                  existing Employment Strategies
                                               preliminary steps necessary for                         homeless or formerly incarcerated.                     Evidence Review (ESER) (https://
                                               assessing effectiveness. This included                                                                         www.acf.hhs.gov/opre/resource/
                                               categorizing each study’s findings                      2.0 Process for Establishing the Criteria
                                                                                                                                                              employment-strategies-for-low-income-
                                               according to whether it found positive,                 of Effectiveness for the New What
                                                                                                                                                              adults-evidence-review-standards-and-
                                               negative or null impacts for the                        Works Clearinghouse
                                                                                                                                                              methods), which are broadly consistent
                                               interventions studied. In addition,                       In fall 2017 and early winter 2018,                  with other federal Clearinghouses.
                                               through a number of synthesis briefs                    OPRE engaged in a series of systematic                 ESER’s standards and methods (e.g.,
                                               (published on the website), ESER                        consultations with federal and non-                    author queries; number and training of
                                               qualitatively and quantitatively                        federal technical experts on evidence                  reviewers; choices about reporting effect
                                               summarized the direction of impacts for                 reviews. In addition to representation                 sizes) were developed by considering
                                               different interventions and highlighted                 from the Department of Labor (DOL) and                 both the choices made by other federal
                                               interventions associated with the                       the Department of Education (ED) in                    and non-federal Clearinghouses and the
                                               greatest number of positive impacts.                    these consultations, federal                           standards of research in the
                                                  To be included in ESER, studies had                  representation included the Department                 employment and training intervention
                                               to—                                                     of Justice (DOJ) and a number of HHS
                                                  • Quantitatively measure the                                                                                field. Other existing federal
                                                                                                       agencies/offices including the Office of               Clearinghouses have followed this same
                                               effectiveness of a program or strategy
                                                  • Be published between 1990 and                      Family Assistance (OFA), the Office of                 approach (considering both the choices
                                               2014                                                    Planning, Research, and Evaluation                     made by other clearinghouses and the
                                                  • Study an employment program or                     (OPRE), the Office of the Assistant                    norms of research within their fields of
                                               strategy— an intervention— that                         Secretary for Planning and Evaluation                  focus).
                                                  Æ had a primary aim of improving                     (ASPE) and the Agency for Healthcare                      • In any instances where the new
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                                               employment-related outcomes                             Research and Quality (AHRQ).                           Clearinghouse’s ratings of a project’s
                                                  Æ primarily targeted low-income                        The objective of these consultations                 strength of evidence or effectiveness
                                               adults                                                  was to help HHS:                                       differ from another federal evidence
                                                  Æ took place in the United States,                     (1) Develop criteria for categorizing                review that rates projects according to
                                               Canada, or the United Kingdom                           interventions in the new Clearinghouse                 the same outcomes (such as the
                                                  To identify studies eligible for review,             as proven, promising, developmental, or                Department of Labor’s (DOL’s)
                                               ESER issued a call for papers,                          ineffective,                                           Clearinghouse for Labor Evaluation and


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                                               26292                         Federal Register / Vol. 83, No. 109 / Wednesday, June 6, 2018 / Notices

                                               Research (CLEAR)), annotate the                         3.2 Proposed Criteria for Evidence of                  3.2.2.3 Pre-Defining Criteria for
                                               findings to explain the reason for the                  Effectiveness for Projects Included in the             Selecting Among Multiple Outcome
                                               difference.                                             Clearinghouse                                          Measures
                                               2.3 Provides Opportunity for Public                     3.2.1 Definition of Project and                          HHS intends to reduce the likelihood
                                               Comment                                                 Approach                                               for reporting a false positive rate for
                                                                                                          The legislation requires that ratings,              outcomes—an issue that can occur
                                                  To provide an opportunity for public                 or categorizations, of evidence of                     when studies use multiple measures or
                                               comment on the criteria for                             effectiveness be applied to projects and               multiple outcomes to assess impacts in
                                               effectiveness, ACF is publishing this                   approaches. To standardize definitions                 the same domain (e.g., short-term
                                               Federal Register Notice.                                for these terms, HHS intends to define                 earnings)—by relying on the decision
                                                                                                       a project and an approach as follows:                  rules ESER developed to address the
                                               2.4 Takes Into Account Efforts of
                                                                                                          • Define project to be a specific                   potential for multiple comparisons.
                                               Federal Agencies To Identify and                                                                               https://www.acf.hhs.gov/opre/resource/
                                                                                                       bundle of services and/or policies
                                               Publicize Effective Interventions                       implemented in a given context.                        employment-strategies-for-low-income-
                                                  To ensure the Clearinghouse reflects                    • Project will be the unit that receives            adults-evidence-review-standards-and-
                                               the learning of other Federal agencies                  an effectiveness rating (i.e. proven,                  methods).
                                                                                                       promising, developmental, or
                                               about how to identify and publicize                                                                            3.2.2.4 Application of Evidence of
                                                                                                       ineffective).
                                               effective interventions, HHS intends to                    • Define approach to be the guiding                 Effectiveness Ratings
                                               implement the following practices:                      framework of specific services (e.g.,                     HHS intends that evidence of
                                                  • Use some of the methods adopted                    career pathways).                                      effectiveness ratings will be applied
                                               by other clearinghouses to create                          • Approaches will not be rated as                   within outcome domains; each project
                                               multiple products tailored to different                 proven, promising, developmental, or                   will receive ratings of effectiveness on
                                               audiences and use graphic design and                    ineffective, but the Clearinghouse will                each outcome domain (e.g., a project
                                               other user-friendly dissemination                       include narrative summaries related to                 may be found promising for short-term
                                               elements to help users digest evidence                  different approaches.                                  employment but ineffective for long-
                                               quickly.                                                   • While the legislation does not                    term employment). There will be no
                                                                                                       require HHS to define or evaluate the                  overall rating for the project.
                                                  • Include information on the                         effectiveness of program components,
                                               Clearinghouse website that is especially                there is interest in the field in                      3.2.3   Definition of Proven
                                               useful to practitioners, such as summary                examining program components. Thus,                      The legislation directs HHS to
                                               information about projects and                          HHS intends that the Clearinghouse                     categorize projects as Proven,
                                               approaches.                                             include meta-analyses of specific                      Promising, Developmental, or
                                                  • Develop and incorporate alternative                components of projects (such as ‘‘case                 Ineffective.
                                               media for the Clearinghouse such as                     management’’ or ‘‘job search                             HHS intends that for a project to be
                                               videos that will tailor communication to                assistance’’) whenever appropriate and                 considered proven, the following
                                               various groups.                                         feasible.                                              conditions must be met:
                                                  • Ensure that information is                         3.2.2 Parameters Guiding the                             • There must be at least two separate
                                               effectively conveyed on the                             Application of Evidence of Effectiveness               studies of the same project that meet
                                               Clearinghouse website by soliciting                     Ratings                                                evidence standards and meet criteria for
                                               feedback from various stakeholders who                     Before a project can be categorized as              a promising rating.
                                               can represent key target audiences. Key                 being proven, promising,                                 Æ Studies are considered to be
                                               among these would be state or county                    developmental, or ineffective, a number                separate studies of the same project if
                                               Temporary Assistance for Needy                          of preliminary definitions, or                         they use non-overlapping samples to
                                               Families (TANF) and Workforce                           parameters, must be established to guide               examine distinct implementations of the
                                                                                                       decision making. These include the                     project.
                                               Development practitioners, as well as
                                               evaluation researchers.                                 outcomes for which a project’s                           • There must be only favorable or
                                                                                                       effectiveness will be evaluated, how a                 null impacts within a given outcome
                                               3.0 Proposed Criteria for Evidence of                   favorable or unfavorable effect will be                domain. Thus, no studies that meet
                                               Effectiveness                                           measured, and how an effectiveness                     evidence standards for a given outcome
                                                                                                       rating will be applied to a project.                   domain can show an unfavorable impact
                                               3.1 Criteria for Well-Designed,                                                                                within that domain.
                                               Rigorous Impact Research                                3.2.2.1 Outcomes
                                                                                                                                                                • Projects that have both favorable
                                                                                                         HHS intends that the new                             and unfavorable impacts in a given
                                                  HHS intends to employ the criteria
                                                                                                       Clearinghouse will review the following                domain will be categorized as mixed.
                                               established by OPRE’s Employment
                                                                                                       outcomes:                                                • A project has a limited number, or
                                               Strategies for Low-Income Adults                          Æ Employment (short and longer-
                                               Evidence Review (ESER) to assess the                                                                           proportion, of null findings in a given
                                                                                                       term),                                                 domain.
                                               quality of study design and to assess the                 Æ earnings (short and longer-term),
                                               strength of the evidence resulting from                   Æ educational attainment, and                          HHS is soliciting comments on how to
                                               studies. These criteria (referred to as                   Æ public benefit receipt.                            best determine the ceiling for the
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                                               ‘‘standards and methods’’) are available                                                                       number, or proportion, of null to
                                                                                                       3.2.2.2 Definition of Favorable and                    positive findings in a given domain.
                                               in ESER’s Standards and Methods report                  Unfavorable Effects
                                               https://www.acf.hhs.gov/opre/resource/                                                                           If subsequent studies or replications
                                               employment-strategies-for-low-income-                      HHS intends that the Clearinghouse                  result in only null findings in a given
                                                                                                       consider only statistically significant                domain, the review will establish
                                               adults-evidence-review-standards-and-
                                                                                                       findings (p <.05) as evidence of                       procedures for revisiting a project’s
                                               methods.
                                                                                                       favorable or unfavorable effects.                      rating of proven.


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                                                                             Federal Register / Vol. 83, No. 109 / Wednesday, June 6, 2018 / Notices                                                  26293

                                               3.2.4    Definition of Promising                           • The studies find both favorable and               FOR FURTHER INFORMATION CONTACT:
                                                 HHS intends that for a project to be                  unfavorable impact estimates within the                Rachel Moscato, Program Coordinator,
                                               considered promising, the following                     same domain.                                           Delta Region Community Health
                                                                                                          3.2.8 HHS intends that narrative                    Systems Development, Federal Office of
                                               conditions must be met:
                                                                                                       descriptions of rated projects, narrative              Rural Health Policy, HRSA, RMoscato@
                                                 • One study of a project must meet
                                                                                                       descriptions of approaches, and                        hrsa.gov.
                                               evidence standards.
                                                                                                       information on case studies be provided
                                                 • That study must find only favorable                                                                        Background
                                                                                                       to users of the Clearinghouse to
                                               or null impacts within a given outcome
                                                                                                       facilitate a fuller understanding of the
                                               domain. Thus no studies that meet                                                                                The Delta Region Community Health
                                                                                                       field of welfare-to-work interventions.
                                               evidence standards for an outcome                                                                              Systems Development program is
                                               domain can show an unfavorable impact                   4.0 Submission of Comments                             authorized by Section 711(b) of the
                                               within the domain.                                        Comments may be submitted until                      Social Security Act, (42 U.S.C. 912 (b)),
                                                 Æ If the review examines more than                    August 5, 2018 by email to                             as amended.
                                               one measure to identify impacts on a                    OPREinfocollection@acf.hhs.gov.                          HRSA established the Delta Region
                                               particular domain (e.g., Unemployment
                                               Insurance data and participant survey                   Naomi Goldstein,                                       Community Health Systems
                                               data), as long as one measure (among                    Deputy Assistant Secretary for Planning,               Development Program in FY 2017,
                                               those selected according to 3.2.2.3                     Research, and Evaluation.                              under announcement HRSA–17–117,
                                               above) finds favorable impacts for that                 [FR Doc. 2018–12160 Filed 6–5–18; 8:45 am]             providing up to $2,000,000 per year to
                                               outcome, the intervention can receive a                 BILLING CODE 4184–09–P                                 one awardee, the Rural Health Resource
                                               Promising rating for that outcome.                                                                             Center for a three-year project period:
                                                 • Projects that have both favorable                                                                          September 30, 2017 through September
                                               and unfavorable impacts in a given                      DEPARTMENT OF HEALTH AND                               29, 2020. The FY 2018 House Report
                                               domain will be categorized as mixed.                    HUMAN SERVICES                                         115–244 and Senate Report 115–150
                                                                                                                                                              Division H of the Consolidated
                                               3.2.5    Definition of Ineffective                      Health Resources and Services                          Appropriations Act of 2018 (Pub. L.
                                                  HHS intends that for a project to be                 Administration                                         115–141) provided direction that an
                                               considered ineffective, the following                   Notice of Single Source Award Based                    additional $2,000,000 included in the
                                               conditions must be met:                                 on Non-Statutory Earmark to the Delta                  appropriation to be used to support the
                                                  • One or more studies of a project                   Region Community Health Systems                        Delta Program. HRSA plans to increase
                                               must meet evidence standards.                           Development Program                                    the maximum funding per year for the
                                                  • There must be only findings of                                                                            Delta Region Community Health
                                               unfavorable or null effects in a given                  AGENCY: Health Resources and Services                  Systems Development Program to
                                               domain.                                                 Administration (HRSA), Department of                   $4,000,000 for one award recipient in
                                                  • For studies finding null effect in a               Health and Human Services.
                                                                                                                                                              FY 2018, as well as in subsequent
                                               given domain, the review will include a                 ACTION: Notice.                                        budget periods within the three-year
                                               measure of statistical precision—so that
                                                                                                       SUMMARY:   The purpose of the Delta                    project period, should funds become
                                               small, under-powered studies do not
                                                                                                       Region Community Health Systems                        available.
                                               drive the effectiveness rating. If an
                                               intervention has been evaluated using                   Development Program is to support                      Conclusion
                                               only small studies, a lack of detectable                collaboration with and input from the
                                               effects could reflect either                            Delta Regional Authority to develop a                     HRSA will provide $2,000,000 in
                                               ineffectiveness of the intervention or the              pilot program to help underserved rural                additional resources to the current
                                               lack of statistical power to detect effects.            communities in the Delta region identify               award recipient, the Rural Health
                                               It would be misleading to characterize                  and better address their health care                   Resource Center in FY 2018 to support
                                               this latter scenario as an ineffective                  needs and to help small rural hospitals                additional activities within the scope of
                                               project.                                                improve their financial and operational                the Delta Region Community Health
                                                                                                       performance. HRSA received an                          Systems Development Program. The
                                               3.2.6    Definition of Developmental                    additional $2,000,000 in FY 2018 to                    recipient will utilize its existing
                                                 HHS intends that for a project to be                  support the Delta Region Community                     infrastructure and a multipronged
                                               considered developmental, the                           Health Systems Development Program,
                                                                                                                                                              approach to deliver intensive assistance
                                               following conditions must be met:                       increasing the total FY 2018 resources
                                                                                                                                                              to all eight Delta Region communities,
                                                 • There must be at least one current,                 from $2,000,000 to $4,000,000. The
                                                                                                                                                              including onsite assessments in
                                               ongoing evaluation of the project that                  single award recipient, the Rural Health
                                                                                                       Resource Center has a need for                         financial, operational performance, and
                                               uses a study design that meets evidence                                                                        quality improvement in the areas of
                                               standards but has not yet produced                      additional funds to support activities
                                                                                                       performed within the scope of this                     population health, social services,
                                               impact findings.
                                                                                                       program. The center will use a                         emergency medical services, and
                                               3.2.7 Additional Category of Mixed                      multipronged approach to deliver                       telehealth. Please direct any questions
                                               and Definition of Mixed                                 phased-in technical assistance (TA) to                 or concerns to RMoscato@hrsa.gov.
                                                 HHS intends that there be an                          all eight Delta Region communities.                     Dated: May 31, 2018.
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                                               additional category for categorizing                    ADDRESSES: Further information on the                  George Sigounas,
                                               evidence of effectiveness called mixed.                 Delta Region Community Health                          Administrator.
                                               HHS proposes that for a project to be                   Systems Development Program is
                                                                                                                                                              [FR Doc. 2018–12141 Filed 6–5–18; 8:45 am]
                                               considered mixed, the following                         available at: https://www.hrsa.gov/
                                               conditions must be met:                                 ruralhealth/programopportunities/                      BILLING CODE 4165–15–P

                                                 • One or more studies of a project                    fundingopportunities/?id=8d869eff-
                                               must meet evidence standards.                           0bca-4703-a821-88a9f0433b73.


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Document Created: 2018-06-06 00:53:43
Document Modified: 2018-06-06 00:53:43
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
ActionRequest for public comment.
FR Citation83 FR 26290 

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