Web Based Training for Pain Management Providers (NIDA)

Forms and Documents

Document Name	Status
Form 2 Health Care Providers Form	New
Supporting Statement B 4_12_10.docx Supporting Statement B	2010-04-30
Attachment 2 4_12_10.docx Supplementary Document	2010-04-30
Attachment 1 4_12_10.docx Supplementary Document	2010-04-30
Attachment 4 4_12_10.docx Supplementary Document	2010-04-30
Supporting Statement A rev 8 20 2010 -2213 rvsn incentive.docx Supporting Statement A	2010-08-23

IC Document Collections

IC ID	Document Title	Status
192912	Health Care Providers Form	New

ICR Details

OMB Control No: 0925-0621	ICR Reference No: 201005-0925-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Web Based Training for Pain Management Providers (NIDA)
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: 08/29/2010
	Date Received in OIRA: 05/17/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2012	08/31/2012
Responses	240	0	0
Time Burden (Hours)	180	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: An evaluation of the program will be conducted in a home or office setting with 80 pain management providers (PMPs) such as physicians, NPs, and PAs. The proposed evaluation design is a two-group (intervention and control group), randomized trial with a crossover component. The major hypotheses for the proposed evaluation are: 1) PMPs in the intervention group will show greater gains in knowledge and improvements in attitude (from pre- to post-assessment) than participants in the control group; 2) PMPs in the intervention group will show greater gains in clinical skills as measures than those in the control group; and 3) PMPs in the intervention group will retain changes in knowledge, attitudes and skills over the follow-up period of six to nine weeks.

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Authorizing Statute(s): US Code: 42 USC 191 Name of Law: General Purpose of NIDA
  

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:
	75 FR 6208	02/08/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 2197	04/23/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Health Care Providers	2, 1	Screening Instrument ,   Assessment Instrument

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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	240	0	0	240	0	0
Annual Time Burden (Hours)	180	0	0	180	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 collection of information.

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Annual Cost to Federal Government: $749,643

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]? No

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: 05/17/2010

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