IHS HPDP OMB SUPPORTING STATEMENT-rev060309

IHS HPDP OMB SUPPORTING STATEMENT-rev060309.doc

IHS Health Promotion/Disease Prevention Grantee Survey

OMB: 0917-0033

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Supporting Statement for Indian Health Service

Health Promotion/Disease Prevention Grantee Survey in

42 or 45 CFR XXX.XXX


Background

The IHS goal is to raise the health status of the American Indian and Alaska Native (AI/AN) people to the highest possible level by providing comprehensive health care and preventive health services. HP/DP is one of the three IHS Director’s Initiatives to reduce health disparities among AI/populations through a coordinated and systematic approach to enhance health promotion and chronic disease prevention approaches at the local, regional, and national levels.


The HP/DP competitive grant was established in 2005 to encourage Tribal and Urban Indian programs to fully engage their local schools, communities, health care providers, health centers, faith-based/spiritual communities, senior centers, youth programs, local governments, academia, non-profit organizations, and many other community sectors to work together to enhance and promote health and prevent chronic disease in their communities. Thirty-three Tribal/Urban Indian organizations and programs were awarded competitive grants to expand and enhance and expand health promotion and disease prevention to address health disparities among AI/AN populations.


All IHS HP/DP grantees received an official memo notifying them of the expectation to participate in the interview surveys and to provide copies of advance data verification prior to the interviews.


The purpose of evaluation results will be used to improve the overall HP/DP grant program.


A. JUSTIFICATION:


1. Need and Legal Basis


This is a request that the Office of Management and Budget (OMB) approve, under the Paperwork Reduction Act, an Indian Health Service (IHS) information collection initiative to fulfill an OMB request for an independent evaluation of the IHS Health Promotion/ Disease Prevention (HP/DP) grant program.


Indian Health Service will contract with an external independent contractor to perform an objective evaluation of the HP/DP grant program, provide professional oversight and technical expertise in quantitatively evaluating the HP/DP grantees, make recommendations for improvement, identify best/promising practices for expansion, and propose strategies to enhance the overall HP/DP grant program. The evaluation services will require extensive analysis of program effectiveness, communication, coordination, and application of technical knowledge in program evaluation.


The information collected will enable the HP/DP program to:

  1. Meet OMB request for an independent external evaluator to perform extensive analysis of HP/DP grant program effectiveness and prepare a final report.

  2. Meet requirements of the Government Performance and Results Act (GPRA), and

  3. Meet requirements of the Program Assessment Rating Tool (PART).


2. Information Users

To conduct a thorough evaluation of the grant program, twenty-nine telephone and 4 face-to-face interviews will be conducted to collect information to complete a quantitative and qualitative evaluation of HP/DP grant program. The teleconference interviews may include one to seven staff members per site. Each of the Tribal/Urban organization/program will determine the number of staff members to participate in the interview. The evaluation will include an assessment of whether HP/DP grantees achieve measurable health outcomes, and synthesize the evaluation findings, and include a written report with recommendations to enhance program effectiveness. The information gathered will be used to prepare a final report for OMB. No personally identifying health information will be collected as a result of this evaluation. In addition to the interviews, the grantees will provide advance data verification prior to the scheduled interviews. 



The purpose of the report includes:

a) Determination of whether HP/DP grantees achieve positive measurable health outcomes in communities. Health outcome may be tied to relevant IHS clinical GPRA and PART measures where appropriate;

b) Reporting of outcomes of program goals, and reviewing program/grantee goals to ensure they fulfill the purpose of the HP/DP program;

c) Internal and external collaboration;

d) Special conditions;

e) New resources secured;

f) Intervention outcomes;

g) Barriers identified;

h) Evaluation needs;

i) Forecasting future needs.


3. Improved Information Technology


As appropriate, automated information technology will be used to collect and process information for these surveys. The most appropriate methodology will involve telephone interviews and face-to-face interviews with grantees program staff to collect written and oral responses to the survey.


4. Duplication of Similar Information


The Health Promotion/Disease Prevention program does not currently collect information through phone survey, questionnaires, or automated information technology. A source of evaluation information on the HD/DP program does not exist.



  1. Small Businesses


This information collection will not solicit information from small businesses or other small entities and therefore deemed to have no impact on small business


6. Less Frequent Collection


No frequent collection will be involved. This is a one time survey to fulfill OMB request for an independent external evaluation of the HP/DP grant program. Survey a single point in time will be conducted with 33 Tribal/Urban organizations program staff which may consist of 1 to 7 staff members per site. Respondents must respond this one time. The purpose of the survey is to assess the effectiveness and impact of the interventions carried out by HD/DP grantees. There are no legal obstacles to reduce the burden.


7. Special Circumstances


The data will be collected in a manner consistent with the guidelines in 5 CFR 1320.5.; this project fully complies with the regulation.


  1. Federal Register Notice/Outside Consultations


No comments received in the Federal Register Notice.


  1. Payment/Gift to Respondents


No payment or gift will be provided to respondents.


10. Confidentiality


The only information collected will be the respondents name, business phone number and address; No personally identifying information will be collected


11. Sensitive Questions


No questions of a sensitive nature will be collected


12. Burden Estimates (Total Hour & Wages)


Annualize total cost: The estimated annualized hourly burden of the surveys is the sum of the burden to the respondents plus the burden to the Federal Government as summarized below and which is $16,170 for respondents plus $3300 for the Federal Government which is a total of $19,470.


Summary of Annualized Burden Hours and Cost - Total


Survey

Number of

Surveys Administered per Year

Time Burden

per Survey

(minutes)

Total Time Burden

(hours)

Total Cost at $70.00 per hour

Respondents

HP/DP Grantees Telephone and Face-to-Face Interview Survey




Federal Government

HP/DP Grantees Telephone and face-to-face Interview Survey


231






33


60 minutes






60 minutes


231






33


$16,170


Total Cost at $100.00 per hour


$3300

Total

264


264

$19,470



A. Estimate Annualized Burden Hours

The independent contractor will contact Tribal/Urban organizations directly to conduct telephone and face-to-face interviews. The estimated burden hour(s) for respondents is 231 hours over a 3-month period of this collection (33 sites times 7 respondents per site times 1 hour per responses equals 231 burden hours). The independent contractor will conduct telephone interviews, make 4 face-to-face interviews, and complete the analysis. The estimated burden hour(s) for the Federal Government is 33 hours over a 3-month period. The collection time for the Federal Government includes completing and collating the instruments and results. Estimated cost includes 2 to 3 contractor staff to conduct telephone and face-to-face survey interviews with 33 Tribal/Urban Indian organizations and programs (grantees).


B. Annualize hourly burden to respondents: There is no cost to respondents other than their time to agree to respond to the survey to complete the data collection instrument. The estimated annualized cost to respondents, as a group, is $16,170 (231 burden hours x $70 per hour per site).


Summary of Annualized Burden Hours and Cost - Respondents


Survey

Number of

Surveys Administered per Year

Time Burden

per Survey

(minutes)

Total Time Burden

(hours)

Total Cost at $70.00 per hour

HP/DP Grantees Telephone and Face-to-Face Interview Survey

231

60 minutes

231

$16,170

Total

231


231

$16,170




  1. Capital Costs (Maintenance)


There is no capital, operating and/or maintenance costs to respondents or record keepers to report for this collection.


  1. Cost to the Federal Government


  • Annualize hourly burden to the Federal Government: The cost burden to the Federal government is cost for the independent evaluator to design the survey instrument, conduct data collection, producing paper copies of the instruments, analyze data, and prepare a final report. The instruments will be administered verbally through telephone and face-to-face interviews. The estimated cost for Federal Government is $3300 (33 burden hours times $100.00 per hour).


  • Annualize total cost: The estimated annualized hourly burden of the surveys is the sum of the burden to the respondents plus the burden to the Federal Government as summarized below and which is $16,170 for respondents plus $3300 for the Federal Government which is a total of $19,470.


Summary of Annualized Burden Hours and Cost - Total


Survey

Number of

Surveys Administered per Year

Time Burden

per Survey

(minutes)

Total Time Burden

(hours)

Total Cost at $70.00 per hour

Respondents

HP/DP Grantees Telephone and Face-to-Face Interview Survey




Federal Government

HP/DP Grantees Telephone and face-to-face Interview Survey


231






33


60 minutes






60 minutes


231






33


$16,170


Total Cost at $100.00 per hour


$3300

Total

264


264

$19,470


15. Program or Burden Changes


This is new information collection.


16. Publication and Tabulation Dates


Final report will be submitted to OMB. No publication is expected.


  1. Expiration Date


The OMB information will be displayed on the data collection instrument accordingly.


  1. Certification Statement


Emergency clearance is being requested.


B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS:


1. Respondent Universe and Sampling Methods


The responses will be 33 IHS HP/DP competitive grant recipients. The independent evaluator will contact the grantees directly to arrange and conduct telephone interviews. Coordination of four on-site interviews will be conducted by independent evaluator using the telephone interview survey instrument.


The interviews are to be conducted with all 33 Indian Health Service Health Promotion/Disease Prevention grant recipients since inception of the competitive grant program in 2005.


2. Procedures for the Collection of Information


The independent evaluation contractor staff will collect telephone and face-to-face interview surveys with 33 Tribal/Urban Indian organizations and programs to complete data collection that is consistent with the following principles:


  • The independent contractor staff will contact the grantees directly to schedule and conduct telephone and face-to-face interviews with appropriate program staff identified by each of the grantees.


  • Efforts will be made to obtain the highest possible response rates by encouraging the grantees to participate to enhance the HP/DP grant program.


3. Methods to Maximize Response Rates and Deal with Nonresponse


Consistent with sound survey methodology, the design of the quantitative and qualitative survey will include approaches to maximize the response rates by informing them the importance to enhance the HP/DP grant program. All IHS HP/DP grantees received an official memo notifying them of the expectation to participate in the interview surveys and to provide copies of advance data verification prior to the interviews. The memo also referenced “45 Code Federal Regulation 92.42, the awarding agency and the Comptroller General of the United States, or any of their authorized representatives, shall have the right of access to any pertinent books, documents, papers, or other records of grantees and subgrantees which are pertinent to the grant, in order to make audits, examinations, excerpts, and transcripts.”

A follow up telephone call will be scheduled to encourage the grantees to participate in the interview.


4. Tests of Procedures or Methods to be Undertaken


The data collection instruments have undergone extensive trial and revision to minimize burden and improve their usefulness. No pretesting was conducted. All the questions are directly linked to the grantee program proposals that were submitted for funding. 


5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data


HP/DP hired an external independent contractor who developed the survey and procedures for conducting the survey, including administering the survey, analyzing the information collected and identifying the appropriate staff to administer and analyze the survey.


Alberta Becenti

IHS HP/DP Program, Albuquerque, NM

Telephone: 505-248-4238

Laverne Morrow Carter, Ph.D., MPH
President/Managing

Principal
REsearch and Evaluation SolutionS, Inc.(REESSI)
6281 Franconia Rd., Suite 277
Alexandria, VA 22310
703-313-4934 (Phone)
703-313-6196 (Fax)


LIST OF ATTACHMENTS


Indian Health Service HP/DP Interview Survey

Notification Letter









































Indian Health Service Health Promotion/Disease Prevention


INTERVIEW SURVEY


REESI Inc. is evaluating the impact and effectiveness of the Indian Health Service (IHS) Health Promotion / Disease Prevention grant programs and is contacting all current and past IHS HP/DP grantees to complete the evaluation.  Please help IHS improve these programs by completing this short survey.  The telephone interview is expected to take 1 hour.

Category/Questions

Response Patterns

1=Strongly disagree

7=Strongly agree

Program Operations

We have/had no difficulty in meeting the administrative (hiring staff, training staff, planning, recruitment, preparing materials, budgets) objectives for our HPDP project.

1 2 3 4 5 6 7

We have the necessary resources (staff, money, equipment, facilities) etc. to carry out the program.

1 2 3 4 5 6 7

The goals that we set forth in our proposed intervention are/were realistic for our audience of focus.

1 2 3 4 5 6 7

Staff is/were knowledgeable about all aspects of the program (timelines, reports, objectives).

1 2 3 4 5 6 7

What comments would you like to share about the operations of your program?

Write comments. Verbally verify comments

Service Delivery

We are delivering/delivered the services we proposed to the intended audience.

1 2 3 4 5 6 7

Clients are/were aware of the services we offer(ed) through our funded HPDP program.


1 2 3 4 5 6 7

Clients are/were satisfied with the services they receive (d) from the funded HPDP program we offer(ed)

1 2 3 4 5 6 7

Clients would recommend other people for our HPDP program.

1 2 3 4 5 6 7

Clients have/had opportunities to offer feedback on how to improve the program (examples-surveys, conversations with staff or a suggestion box).

1 2 3 4 5 6 7

What comments would you like to share about your service delivery?

Write comments. Verbally verify comments

Program Outcomes

Our program data show that our outcome goals and objectives are being met/were met.

1 2 3 4 5 6 7

Our services for the funded HPDP program are reaching/reached the intended audience.

1 2 3 4 5 6 7

Clients have/had an improved quality of life after participating in our HPDP program.

1 2 3 4 5 6 7

Clients are more knowledgeable about their health and ways to improve their health since receiving services from our HPDP program.

1 2 3 4 5 6 7

Our program evaluation included measurable health outcomes in communities tied to Government Performance & Results Act (GPRA) or Performance Assessment Rating Tool (PART) performance measures.

1 2 3 4 5 6 7

What comments would you like to share about the outcomes of your programs and the impact it has had on participants?

Write comments. Verbally verify comments




Indian Health Service Health Promotion/Disease Prevention


INTERVIEW SURVEY



Clients are more knowledgeable about their health and ways to improve their health since receiving services from our HPDP program.

1 2 3 4 5 6 7

Our program evaluation included measurable health outcomes in communities tied to Government Performance & Results Act (GPRA) or Performance Assessment Rating Tool (PART) performance measures.

1 2 3 4 5 6 7

What comments would you like to share about the outcomes of your programs and the impact it has had on participants?

Write comments. Verbally verify comments



Indian Health Service Health Promotion/Disease Prevention


NOTIFICATION LETTER


Reference: Fiscal Year 2005 Health Promotion/Disease Prevention Grant





Dear:


This letter is in reference to the Fiscal Year (FY) 2005 Health Promotion/Disease Prevention (HP/DP) grant award in the amount of $64,500. The Office of Management & Budget (OMB) had requested for an independent external evaluator to conduct an evaluation of the overall HP/DP grant program to assess the effectiveness of the program and make recommendations to enhance the program.


In response to OMB request, this serves as an advance notification that IHS is contracting with REsearch and Evaluation SolutionS, Inc, (REESSI) to conduct the evaluation. REESSI will be contacting your office to schedule a telephone interview and will request copies of evidence data and information in advance of the interviews. Evidence data and information are linked to categories of questions in the interview. Please note, IHS has compiled with the provisions of the Paperwork Reduction Act of 1995 by submitting to OMB a request to collect additional information in the form of an evaluation. This additional step was added in order to ensure that the evaluation collection does not place an undue paperwork burden on the grantee.


According to 45 Code Federal Regulation 92.42, the awarding agency and the Comptroller General of the United States, or any of their authorized representatives, shall have the right of access to any pertinent books, documents, papers, or other records of grantees and subgrantees which are pertinent to the grant, in order to make audits, examinations, excerpts, and transcripts. Please make sure that all records are retained for three years from the date the grantee submits its final financial status report or later there is an open litigation, claim, negotiation, audit or any other action involving the affected records.


Please be prepared that you will be requested to provide information as outlined in this document.


Program Operations

Project Position Descriptions (actual)

Project Org Chart (actual)

List of partners and collaborations

Title and amount of any supplemental funding


Service Delivery


Dated Sign-In Sheets

Sample of participant registration forms

Sample of participant feedback forms

Sample outreach materials (one example from each method used)


Program Outcomes

Evidence of the number of participants who actually completed the program

Pre-Post Test samples

Other samples of success


The evaluation results will be used to enhance the overall HP/DP grant program. If you should have any questions, please call me at (301) 443-4305 or email me at Alberta.becenti@ihs.gov.


Sincerely,



Alberta Becenti, Consultant

Health Promotion/Disease Prevention

























Reference: Fiscal Year 2006 Health Promotion/Disease Prevention Grant






Dear:


This letter is in reference to the Fiscal Year (FY) 2006 Health Promotion/Disease Prevention (HP/DP) grant award in the amount of $100,000. The Office of Management & Budget (OMB) had requested for an independent external evaluator to conduct an evaluation of the overall HP/DP grant program to assess the effectiveness of the program and make recommendations to enhance the program.


In response to OMB request, this serves as an advance notification that IHS is contracting with REsearch and Evaluation SolutionS, Inc, (REESSI) to conduct the evaluation. REESSI will be contacting your office to schedule a telephone interview and will request copies of evidence data and information in advance of the interviews. Evidence data and information are linked to categories of questions in the interview. Please note, IHS has compiled with the provisions of the Paperwork Reduction Act of 1995 by submitting to OMB a request to collect additional information in the form of an evaluation. This additional step was added in order to ensure that the evaluation collection does not place an undue paperwork burden on the grantee.


According to 45 Code Federal Regulation 92.42, the awarding agency and the Comptroller General of the United States, or any of their authorized representatives, shall have the right of access to any pertinent books, documents, papers, or other records of grantees and subgrantees which are pertinent to the grant, in order to make audits, examinations, excerpts, and transcripts. Please make sure that all records are retained for three years from the date the grantee submits its final financial status report or later there is an open litigation, claim, negotiation, audit or any other action involving the affected records.


Please be prepared that you will be requested to provide information as outlined in this document.


Program Operations

Project Position Descriptions (actual)

Project Org Chart (actual)

List of partners and collaborations

Title and amount of any supplemental funding


Service Delivery


Dated Sign-In Sheets

Sample of participant registration forms

Sample of participant feedback forms

Sample outreach materials (one example from each method used)


Program Outcomes

Evidence of the number of participants who actually completed the program

Pre-Post Test samples

Other samples of success


The evaluation results will be used to enhance the overall HP/DP grant program. If you should have any questions, please call me at (301) 443-4305 or email me at Alberta.becenti@ihs.gov.


Sincerely,



Alberta Becenti, Consultant

Health Pro

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