Non-Substantive Change Memo

Health Resources and Services DEPARTMENT OF HEALTH & HUMAN SERVICES Administration Healthcare Systems Bureau Rockville, MD 20857

DATE: August 4, 2022

TO: Josh Brammer, OMB Desk Officer

FROM: Samantha Miller, Acting HRSA Information Collection Clearance Officer

______________________________________________________________________________

Request: The Health Resources and Services Administration (HRSA) National Hypertension Control Initiative (NHCI) requests approval for changes to the AHA NHCI Quarterly Evaluation Survey Instrument: Community Health Center (CHC) Qualtrics Survey (OMB 0990-0482; expiration date 6/30/2025).

Purpose: The purpose of this request is to minimally modify the existing survey instrument that was developed and approved for use by the National Hypertension Control Initiative (NHCI) to allow for the surveillance of an expanded group of NHCI health centers awardees, known as Technical Assistance (TA) Group 2 that are a part of this same initiative. This will allow HRSA to better track and understand differences in program implementation, outcomes, technical assistance needs, and other program needs.

Surveys for TA Group 2 will be distributed using Survey Monkey. Once the survey has been designed in the Survey Monkey application, it will be emailed to each of the 144 Health Centers in TA Group 2. A link to the survey will also be provided through an exclusive Microsoft Teams channel that has been designed especially for TA Group 2.

This memo explains the changes and supporting rationale, which include date changes (due to an altered timeline), rewording of select instructions and tools, refining of language (for improved readability), and simplifying some questions. All of these changes will allow for the same content to be collected with clearer instructions and more accurate data collection.

Changes: Instruments:

The below table includes the number of the question that was altered, a description of the non change, and the rationale for the change. Attached is the instruments with the changes tracked, for reference

Time Sensitivity: The data collection changes must be completed in a timely manner to ensure that the data collection schedule will not experience significant delay. Approval of these changes is requested by August 26^th, to implement the changes in the data collection instruments and to prepare for the timely collection of data critical to the National Hypertension Control Initiative.

Burden: These changes included herein do not substantially change the estimated reporting burden for respondents. Making these changes will allow HRSA to accurately capture data to determine the effects of the NHCI on all NHCI health centers’ workflow and procedures with respect to managing hypertension.

PROPOSED CLARIFICATIONS AND NON-SUBSTANTIVE CHANGES:

Change implemented	Rationale
Changed phrasing from CQSNHCI q4 to clarify that we want the prevalent number of patients with hypertension, so the diagnosis of hypertension may have occurred prior to the visit. Also, since these data will be collected quarterly, changed the time frame of the question	Question is going to be asked quarterly, so time period will need to be updated. Asking for the number may get a more accurate count than asking for a percentage, which may invite the responder to provide a rough estimate
Changed phrasing from CQSNHCI q8a to change the time period and ask for a number instead of a percentage	Question is going to be asked quarterly, so time period will need to be updated. Asking for the number may get a more accurate count than asking for a percentage, which may invite the responder to provide a rough estimate
Changed phrasing from CQSNHCI q8b to change the time period and ask for a number instead of a percentage	Question is going to be asked quarterly, so time period will need to be updated. Asking for the number may get a more accurate count than asking for a percentage, which may invite the responder to provide a rough estimate
Changed phrasing from CQSNHCI q8h to change the time period and ask for a number instead of a percentage	Question is going to be asked quarterly, so time period will need to be updated. Asking for the number may get a more accurate count than asking for a percentage, which may invite the responder to provide a rough estimate
Original CQSNHCI question 13 is split into two questions, first asking if staff are trained on proper procedures, second asking the frequency of training if the response is yes. Additional text outlining proper procedures added.	Questions separated and explanatory text outlining proper procedures clarify the questions for the respondents.
New response added to CQSNHCI question 16: “provider repeats measurement”	Additional response covers a valid and common protocol
Split question 30 into separate questions on staff and patient training techniques	Question 30 is not clear as to whether these training techniques are used for the staff and/or for patients. Splitting this into two separate questions makes this clear.

CQSNHCI: CHC Qualtrics Survey, National Hypertension Control Initiative, Qualtrics and DREaM CHC quarterly survey questions_Final (https://omb.report/icr/202204-0990-005/doc/120467800)

Attachment:

• NHCI TA Group 2 Evaluation Survey (All changes and additions are tracked in the attached document)