[Federal Register: July 31, 2007 (Volume 72, Number 146)]
[Notices]
[Page 41757-41758]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr31jy07-92]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[60Day-07-07BE]
Proposed Data Collections Submitted for Public Comment and
Recommendations
In compliance with the requirement of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995 for opportunity for public comment on
proposed data collection projects, the Centers for Disease Control and
Prevention (CDC) will publish periodic summaries of proposed projects.
To request more information on the proposed projects or to obtain a
copy of the data collection plans and instruments, call 404-639-5960
and send comments to Maryam I. Daneshvar, CDC Acting Reports Clearance
Officer, 1600 Clifton Road, MS-D74, Atlanta, GA 30333 or send an e-mail
to omb@cdc.gov.
Comments are invited on: (a) Whether the proposed collection of
information is necessary for the proper performance of the functions of
the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques or other
forms of information technology. Written comments should be received
within 60 days of this notice.
Proposed Project
Research to Reduce Time to Treatment for Heart Attack/Myocardial
Infraction for Rural American Indians/Alaska Natives (AI/AN)--NEW--
National Center for Chronic Disease Prevention and Health Promotion
(NCCDPHP), Centers for Disease Control and Prevention (CDC).
Background and Brief Description
Every year, approximately 1.1 million Americans have a first or
recurrent heart attack/myocardial infarction (MI) and about one third
of these will be fatal. Early recognition of MI by both the victim and
bystanders followed by prompt cardiac emergency and advanced care has a
direct effect on patient outcomes (heart damage, morbidity and
mortality): the shorter the delay to treatment, the better the
outcomes. Results of a recent Behavioral Risk Factor Survey (BRFSS)
survey showed that public recognition of major MI symptoms and the need
for immediate action by calling 9-1-1 was poor and that there is a need
for increased public health efforts. Patient delay accounts for most of
the lag in treatment.
Data from the National MI Registry show that the greatest disparity
for delay in treatment exists among the racial and ethnic groups of
American Indian/Alaskan Native group. The NATIVE study shows that rural
American Indians presenting with acute MI have marked delays in time to
treatment (12% of patients waited between 12-24 hours and 23% waited
more than 24 hours to present) thus, limiting treatment options; the
primary cause of the delay was due to patient misunderstandings about
the symptoms of MI.
The project will contribute to our understanding of AI/AN
populations and their perceptions of and misconceptions about MI and
the need for immediate treatment. Information gained from this project
will provide the details needed to tailor message(s) for this
population. The agency will develop culturally-tailored messages for
native populations that will contribute to the existing National Heart
Attack program (NHLBI) ``Act in Time'' messages.
There will be a minimum of 84 key informant interviews and 16
persons in the two focus groups. The key informants will consist of
healthcare providers, community leader, and persons who have had an MI.
Key informants will be identified for interviews through a clustered,
multistate snowball sampling technique. In recognition of the tribal
diversity; study participants will represent three AI/AN regions of the
U.S.: Great Plains identified by the Aberdeen Area Indian Health
Service area, the South West distinct to the Phoenix, Albuquerque and
Tucson areas and Alaskan Natives. Interview participants will have
established relationships with tribes or
[[Page 41758]]
are members of tribes, and have a good sense of cultural health
beliefs.
The healthcare provider group will consist of nomination by the
Indian Health Service Chief Medical Officer (IHSCMO), who will nominate
3 MD/NP's or PA's and 3 nurses in each region. The participating
emergency care providers will each be asked to nominate 2 providers
from a cardiology clinic (cardiologists or cardiac nurses) and/or a
pre-hospital (EMT/Paramedic) provider. The 6 original from each region
will subtotal to 18 emergency care providers plus the 2 individuals
they each nominate will subtotal to 36 from each region, a total of 54
pre-hospital and cardiology providers (medical providers) key informant
interviews covering all three regions.
The community key informants will consist of 3 tribal health
directors who will nominate 3 community key informants from each
region, who will then each nominate 2 additional community members to
be interviewed for a sample of 30 community key informants.
The individual key informant interviews of the group of patients
who have had an MI or have a high risk of MI, nominated by the
physicians, nurses and community members will be asked to nominate
individuals whom they know have had or are at risk for a heart attack.
The medical providers and community members asked to participate in the
key informant interviews will equal a minimum of approximately 27
health providers, 15 community members or 42 key informant interview,
each contacts 2 individuals, a minimum of 168 respondents to the
survey.
After the key informant interviews have been completed and analyzed
there will be two community focus groups each comprised of 8 to 10
participants from all three regions held. The first involving patients
who have had an MI and the second focus group will involve community
members at risk for MIs.
There are no costs to the respondent except their time to
participate in the survey.
Estimated Annualized Burden Hours
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Average
Number of No. of burden per Total burden
Respondents respondents responses per response (in (in hours)
respondent hrs.)
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Healthcare providers............................ 54 1 1 54
Community leaders............................... 30 1 1 30
Community members interviews.................... 168 1 1 168
(2) Community member focus group retreats....... 20 1 8 160
Total....................................... .............. .............. .............. 412
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Dated: July 25, 2007.
Maryam I. Daneshvar,
Acting Reports Clearance Officer, Centers for Disease Control and
Prevention.
[FR Doc. E7-14703 Filed 7-30-07; 8:45 am]
BILLING CODE 4163-18-P