83 FR 39757 - Proposed Data Collection Submitted for Public Comment and Recommendations

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention

Federal Register Volume 83, Issue 155 (August 10, 2018)

Page Range		39757-39758
FR Document		2018-17174

The Centers for Disease Control and Prevention (CDC), as part of its continuing effort to reduce public burden and maximize the utility of government information, invites the general public and other Federal agencies the opportunity to comment on a proposed and/or continuing information collection, as required by the Paperwork Reduction Act of 1995. This notice invites comment on a proposed information collection project titled ``Dental Survey: Improving outpatient antibiotic use through implementation and evaluation of Core Elements of Outpatient Antibiotic Stewardship.'' This information collection request will generate data to assess knowledge, attitudes, practices and perceived barriers to appropriate antibiotic prescribing in a representative sample of dental providers. Results will be used to inform interventions for this specific provider population and support our efforts to improve antimicrobial stewardship within outpatient clinics.

Federal Register, Volume 83 Issue 155 (Friday, August 10, 2018)

[Federal Register Volume 83, Number 155 (Friday, August 10, 2018)]
[Notices]
[Pages 39757-39758]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-17174]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-18-18APX; Docket No. CDC-2018-0066]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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

SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies the opportunity to comment on a proposed and/or 
continuing information collection, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on a proposed 
information collection project titled ``Dental Survey: Improving 
outpatient antibiotic use through implementation and evaluation of Core 
Elements of Outpatient Antibiotic Stewardship.'' This information 
collection request will generate data to assess knowledge, attitudes, 
practices and perceived barriers to appropriate antibiotic prescribing 
in a representative sample of dental providers. Results will be used to 
inform interventions for this specific provider population and support 
our efforts to improve antimicrobial stewardship within outpatient 
clinics.

DATES: CDC must receive written comments on or before October 9, 2018.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2018-
0066 by any of the following methods:
     Federal eRulemaking Portal: Regulations.gov. Follow the 
instructions for submitting comments.
     Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS-D74, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to Regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (regulations.gov) or by U.S. mail to the address listed above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS-D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: 
[email protected].

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), Federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also

[[Page 39758]]

requires Federal agencies to provide a 60-day notice in the Federal 
Register concerning each proposed collection of information, including 
each new proposed collection, each proposed extension of existing 
collection of information, and each reinstatement of previously 
approved information collection before submitting the collection to the 
OMB for approval. To comply with this requirement, we are publishing 
this notice of a proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.
    5. Assess information collection costs.

Proposed Project

    Dental Survey: Improving outpatient antibiotic use through 
implementation and evaluation of Core Elements of Outpatient Antibiotic 
Stewardship--New Information Collection Request--National Center for 
Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease 
Control and Prevention (CDC).

Background and Brief Description

    Antibiotic resistance is a growing problem that has been shown to 
be a result of wide-spread antibiotic use and misuse. While efforts to 
improve antibiotic use to date have been primarily implemented in the 
inpatient setting, the majority of antibiotics are prescribed in the 
outpatient setting. Up to 50% of all antibiotics prescribed for acute 
respiratory tract infections (ARI) are proposed to be inappropriate. 
Interventions that have been demonstrated to decrease inappropriate use 
include audit-and-feedback, academic detailing, clinical decision 
support systems (CDSS), provider-focused public commitments to reduce 
inappropriate antibiotic use, and delayed antibiotic prescriptions. 
However, current data is limited due to short study timeframes and lack 
of sustainability.
    In a pilot project, phone interviews were conducted with six dental 
providers and three pediatricians, specifically those who could speak 
to the knowledge, attitudes and behaviors of their peers. PRA was 
deemed not applicable by the NCEZID PRA representative for this pilot. 
We identified six dental providers that were recruited for a phone 
interview with our team's healthcare psychologist. Semi-structured 
interviews were used to assess: (1) Knowledge about antibiotic 
prescribing (what constitutes appropriate and inappropriate 
prescribing); (2) the providers current antibiotic prescribing 
practices; (3) beliefs about the consequences of inappropriate and 
appropriate prescribing (e.g., consequences for the provider, for 
individual patients, and for the healthcare system); (4) attitudes 
about antibiotic prescribing (expected negative and positive reactions 
to appropriate prescribing); (5) subjective norms (beliefs related to 
what is ``normal'' antibiotic prescribing for the provider and for 
peers); (6) control beliefs related to appropriate prescribing (factors 
that make appropriate prescribing easy or difficult, e.g., barriers); 
and (7) future planned behaviors along with perceived solutions to 
promote appropriate antibiotic prescribing.
    During the analysis of the six dental interviews it was determined 
by the team that these interviews contained very unique information in 
terms of knowledge, attitudes and behaviors compared to other non-
dental providers. Therefore, it was also determined that information 
saturation was not reached during this first data collection phase. We 
want to continue our data collect efforts within this specific 
population. This information will be crucial in future design of 
scalable and sustainable outpatient antibiotic stewardship 
interventions that incorporate all Core Elements of Outpatient 
Antibiotic Stewardship and to be able to implement it across a network 
of dental outpatient facilities.
    The total estimated annual Burden Hours are 50. There will be no 
anticipated costs to respondents other than their time.

                                                            Estimated Annualized Burden Hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                             Number of    Average burden
              Type of respondents                               Form name                    Number of     responses per   per response    Total burden
                                                                                            respondents     respondent      (in hours)      (in hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Dental Providers...............................  Dental Survey CDC Outpatient SHEPheRD..             100               1              .5              50
                                                                                         ---------------------------------------------------------------
    Total......................................  .......................................  ..............  ..............  ..............              50
--------------------------------------------------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Acting Chief, Information Collection Review Office, Office of 
Scientific Integrity, Office of the Associate Director for Science, 
Office of the Director, Centers for Disease Control and Prevention.
[FR Doc. 2018-17174 Filed 8-9-18; 8:45 am]
 BILLING CODE 4163-18-P

Federal Register / Vol. 83, No. 155 / Friday, August 10, 2018 / Notices 39757

ESTIMATED ANNUALIZED BURDEN HOURS
Number of Avg. burden
Number of responses Total burden
Type of respondents Form name per response
respondents per (in hrs.)
(in hrs.)
respondent

Traditional Office-based Physicians 2018 Physician Induction Interview 122 1 30/60 61
or Staff. (NAMCS–1).
Traditional Office-based Physicians 2019+ Physician Induction Interview 1,097 1 30/60 549
or Staff. (NAMCS–1).
Traditional Office-based Physicians 2018 Pulling, re-filing medical 99 30 1/60 50
or Staff. record forms (FR abstracts).
Traditional Office-based Physicians 2019+ Pulling, re-filing medical 893 30 1/60 447
or Staff. record forms (FR abstracts).
MU Office-based Physician Staff ...... 2019+ MU Physician Induction 2,000 1 45/60 1,500
Interview (NAMCS–PFI).
MU Office-based Physician Staff ...... 2019+ Pulling, re-filing medical 2,000 1 60/60 2,000
record forms (MU Onboarding).
Community Health Center Executive/ 2018 Induction Interview—service 12 1 30/60 6
Medical Directors. delivery site (NAMCS–201).
Community Health Center Executive/ 2019+ Induction Interview—service 104 1 30/60 52
Medical Directors. delivery site (NAMCS–201).
Community Health Center Providers 2018 Induction Interview—Providers 27 1 30/60 14
(NAMCS–1).
Community Health Center Providers 2019+ Induction Interview—Pro- 234 1 30/60 117
viders (NAMCS–1).
Community Health Center Provider 2018 Pulling, re-filing medical 27 30 1/60 14
Staff. record forms (FR abstracts).
Community Health Center Provider 2019+ Pulling, re-filing medical 234 30 1/60 117
Staff. record forms (FR abstracts).
Traditional Physician Office-based 2018 Pulling, re-filing medical 3 10 1/60 1
and Community Health Center record forms (FR abstracts) for
Staff. the Reabstraction Study.
Traditional Physician Office-based 2019+ Reinterview Study ................ 100 1 15/60 25
and Community Health Center
Staff.

Total ........................................... .......................................................... ........................ ........................ ........................ 4,953

Jeffrey M. Zirger, general public and other Federal • Mail: Jeffrey M. Zirger, Information
Acting Chief, Information Collection Review agencies the opportunity to comment on Collection Review Office, Centers for
Office, Office of Scientific Integrity, Office a proposed and/or continuing Disease Control and Prevention, 1600
of the Associate Director for Science, Office information collection, as required by Clifton Road NE, MS–D74, Atlanta,
of the Director, Centers for Disease Control the Paperwork Reduction Act of 1995. Georgia 30329.
and Prevention. This notice invites comment on a Instructions: All submissions received
[FR Doc. 2018–17175 Filed 8–9–18; 8:45 am] proposed information collection project must include the agency name and
BILLING CODE 4163–18–P titled ‘‘Dental Survey: Improving Docket Number. CDC will post, without
outpatient antibiotic use through change, all relevant comments to
implementation and evaluation of Core Regulations.gov.
DEPARTMENT OF HEALTH AND Elements of Outpatient Antibiotic Please note: Submit all comments
HUMAN SERVICES Stewardship.’’ This information through the Federal eRulemaking portal
collection request will generate data to (regulations.gov) or by U.S. mail to the
Centers for Disease Control and address listed above.
Prevention assess knowledge, attitudes, practices
and perceived barriers to appropriate FOR FURTHER INFORMATION CONTACT: To
[60Day–18–18APX; Docket No. CDC–2018– antibiotic prescribing in a representative request more information on the
0066] sample of dental providers. Results will proposed project or to obtain a copy of
be used to inform interventions for this the information collection plan and
Proposed Data Collection Submitted specific provider population and instruments, contact Jeffrey M. Zirger,
for Public Comment and support our efforts to improve Information Collection Review Office,
Recommendations antimicrobial stewardship within Centers for Disease Control and
AGENCY: Centers for Disease Control and outpatient clinics. Prevention, 1600 Clifton Road NE, MS–
Prevention (CDC), Department of Health D74, Atlanta, Georgia 30329; phone:
CDC must receive written
DATES:
404–639–7570; Email: omb@cdc.gov.
and Human Services (HHS). comments on or before October 9, 2018.
daltland on DSKBBV9HB2PROD with NOTICES

ACTION: Notice with comment period. SUPPLEMENTARY INFORMATION: Under the
ADDRESSES: You may submit comments, Paperwork Reduction Act of 1995 (PRA)
SUMMARY: The Centers for Disease identified by Docket No. CDC–2018– (44 U.S.C. 3501–3520), Federal agencies
Control and Prevention (CDC), as part of 0066 by any of the following methods: must obtain approval from the Office of
its continuing effort to reduce public • Federal eRulemaking Portal: Management and Budget (OMB) for each
burden and maximize the utility of Regulations.gov. Follow the instructions collection of information they conduct
government information, invites the for submitting comments. or sponsor. In addition, the PRA also

VerDate Sep<11>2014 19:03 Aug 09, 2018 Jkt 244001 PO 00000 Frm 00101 Fmt 4703 Sfmt 4703 E:\FR\FM\10AUN1.SGM 10AUN1

39758 Federal Register / Vol. 83, No. 155 / Friday, August 10, 2018 / Notices

requires Federal agencies to provide a New Information Collection Request— prescribing); (2) the providers current
60-day notice in the Federal Register National Center for Emerging and antibiotic prescribing practices; (3)
concerning each proposed collection of Zoonotic Infectious Diseases (NCEZID), beliefs about the consequences of
information, including each new Centers for Disease Control and inappropriate and appropriate
proposed collection, each proposed Prevention (CDC). prescribing (e.g., consequences for the
extension of existing collection of provider, for individual patients, and for
information, and each reinstatement of Background and Brief Description
the healthcare system); (4) attitudes
previously approved information Antibiotic resistance is a growing about antibiotic prescribing (expected
collection before submitting the problem that has been shown to be a negative and positive reactions to
collection to the OMB for approval. To result of wide-spread antibiotic use and appropriate prescribing); (5) subjective
comply with this requirement, we are misuse. While efforts to improve norms (beliefs related to what is
publishing this notice of a proposed antibiotic use to date have been ‘‘normal’’ antibiotic prescribing for the
data collection as described below. primarily implemented in the inpatient provider and for peers); (6) control
The OMB is particularly interested in setting, the majority of antibiotics are beliefs related to appropriate prescribing
comments that will help: prescribed in the outpatient setting. Up (factors that make appropriate
1. Evaluate whether the proposed to 50% of all antibiotics prescribed for prescribing easy or difficult, e.g.,
collection of information is necessary acute respiratory tract infections (ARI) barriers); and (7) future planned
for the proper performance of the are proposed to be inappropriate. behaviors along with perceived
functions of the agency, including Interventions that have been solutions to promote appropriate
whether the information will have demonstrated to decrease inappropriate antibiotic prescribing.
practical utility; use include audit-and-feedback,
2. Evaluate the accuracy of the During the analysis of the six dental
academic detailing, clinical decision
agency’s estimate of the burden of the support systems (CDSS), provider- interviews it was determined by the
proposed collection of information, focused public commitments to reduce team that these interviews contained
including the validity of the inappropriate antibiotic use, and very unique information in terms of
methodology and assumptions used; delayed antibiotic prescriptions. knowledge, attitudes and behaviors
3. Enhance the quality, utility, and compared to other non-dental providers.
However, current data is limited due to
clarity of the information to be Therefore, it was also determined that
short study timeframes and lack of
collected; and information saturation was not reached
4. Minimize the burden of the sustainability.
during this first data collection phase.
collection of information on those who In a pilot project, phone interviews
were conducted with six dental We want to continue our data collect
are to respond, including through the efforts within this specific population.
use of appropriate automated, providers and three pediatricians,
specifically those who could speak to This information will be crucial in
electronic, mechanical, or other future design of scalable and sustainable
technological collection techniques or the knowledge, attitudes and behaviors
of their peers. PRA was deemed not outpatient antibiotic stewardship
other forms of information technology, interventions that incorporate all Core
e.g., permitting electronic submissions applicable by the NCEZID PRA
representative for this pilot. We Elements of Outpatient Antibiotic
of responses. Stewardship and to be able to
5. Assess information collection costs. identified six dental providers that were
recruited for a phone interview with our implement it across a network of dental
Proposed Project team’s healthcare psychologist. Semi- outpatient facilities.
Dental Survey: Improving outpatient structured interviews were used to The total estimated annual Burden
antibiotic use through implementation assess: (1) Knowledge about antibiotic Hours are 50. There will be no
and evaluation of Core Elements of prescribing (what constitutes anticipated costs to respondents other
Outpatient Antibiotic Stewardship— appropriate and inappropriate than their time.

ESTIMATED ANNUALIZED BURDEN HOURS
Average
Number of Total
Type of Number of burden per
Form name responses per burden
respondents respondents response
respondent (in hours)
(in hours)

Dental Providers ................................ Dental Survey CDC Outpatient 100 1 .5 50
SHEPheRD.

Total ........................................... .......................................................... ........................ ........................ ........................ 50

Jeffrey M. Zirger,
Acting Chief, Information Collection Review
Office, Office of Scientific Integrity, Office
of the Associate Director for Science, Office
of the Director, Centers for Disease Control
daltland on DSKBBV9HB2PROD with NOTICES

and Prevention.
[FR Doc. 2018–17174 Filed 8–9–18; 8:45 am]
BILLING CODE 4163–18–P

VerDate Sep<11>2014 19:03 Aug 09, 2018 Jkt 244001 PO 00000 Frm 00102 Fmt 4703 Sfmt 9990 E:\FR\FM\10AUN1.SGM 10AUN1

Document Created: 2018-08-10 01:57:41
Document Modified: 2018-08-10 01:57:41

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice with comment period.
Dates		CDC must receive written comments on or before October 9, 2018.
Contact		To request more information on the proposed project or to obtain a copy of the information collection plan and instruments, contact Jeffrey M. Zirger, Information Collection Review Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS-D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: [email protected]
FR Citation		83 FR 39757

83 FR 39757 - Proposed Data Collection Submitted for Public Comment and Recommendations

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and Prevention

Federal Register Volume 83, Issue 155 (August 10, 2018)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention