Evaluation of the GuideLines Into Decision Support (GLIDES)

Forms and Documents

Document Name	Status
Form Form #6 In-person interviews - Nemours Form and Instruction	New
Form Form #5 In-person interviews - Yale Form and Instruction	New
Form Form #4 Obesity questionnaire -- Nemours Form and Instruction	New
Form Form #3 Obesity questionnaire -- Yale Form and Instruction	New
Form Form #2 Asthma questionnaire -- Nemours Form and Instruction	New
Form Form #1 Asthma questionnaire -- Yale Form and Instruction	New
SS Parts A & B with Responses to OMB -- GLIDES Evaluation 5-25-2010.doc Supplementary Document	2010-06-01
Supporting Statement Part B -- Evaluation of GLIDES -- Response to OMB 6-4-2010.doc Supporting Statement B	2010-06-07
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document	2010-02-03
Attachment L -- Federal Register Notice.pdf Supplementary Document	2010-02-03
Attachment I -- Electronic Data Extraction -- Asthma.xls Supplementary Document	2010-02-03
Attachment H -- Electronic Data Extraction -- Obesity.xls Supplementary Document	2010-02-03
Attachment K -- Online Obesity Questionnaire - Nemours.pdf Supplementary Document	2010-02-03
Attachment J -- Online Asthma Questionnaire - Nemours.pdf Supplementary Document	2010-02-03
Supporting Statement Part A -- Evaluation of GLIDES -- Response to OMB 6-4-2010.doc Supporting Statement A	2010-06-07

IC Document Collections

IC ID	Document Title	Status
192074	In-person interviews - Nemours Form and Instruction	New
192073	In-person interviews - Yale Form and Instruction	New
192072	Obesity questionnaire -- Nemours Form and Instruction	New
192071	Obesity questionnaire -- Yale Form and Instruction	New
192070	Asthma questionnaire -- Nemours Form and Instruction	New
192069	Asthma questionnaire -- Yale Form and Instruction	New

ICR Details

OMB Control No: 0935-0163	ICR Reference No: 201002-0935-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Evaluation of the GuideLines Into Decision Support (GLIDES)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/07/2010
	Date Received in OIRA: 02/23/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2011	12 Months From Approved
Responses	304	0	0
Time Burden (Hours)	51	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: With this project AHRQ proposes to evaluate how the translation of clinical knowledge into clinical decision support can be routinized in practice and taken to scale in ways that improve the quality of healthcare delivery for children in the U.S. Previously in the GLIDES project AHRQ designed and implemented decision support tools based on guidelines for the prevention of pediatric overweight and obesity and the management of chronic asthma in the pediatric population (publication forthcoming). In this phase of the project physicians will be surveyed about their experiences with the decision support tools developed in the previous phase. The participating study institutions (Yale University and Nemours) are geographically and organizationally diverse, and include a wide range of patients from a variety of social, economic and ethnic backgrounds. This project directly addresses AHRQ's mission of "improving health systems practices," in particular for priority populations including low-income groups, minority groups, children, and individuals with chronic diseases.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 62327	11/27/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 5084	02/01/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Asthma questionnaire -- Yale	Form #1	Asthma questionnaire -- Yale
Asthma questionnaire -- Nemours	Form #2	Asthma questionnaire -- Nemours
In-person interviews - Nemours	Form #6	Attachment F -- Interview guide - Nemours
Obesity questionnaire -- Yale	Form #3	Obesity questionnaire -- Yale
Obesity questionnaire -- Nemours	Form #4	Obesity questionnaire -- Nemours
In-person interviews - Yale	Form #5	Attachment G -- Interview guide - Yale

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	304	0	0	304	0	0
Annual Time Burden (Hours)	51	0	0	51	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $5,703

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/23/2010

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