Evaluation of a Kidney Disease Education Program with Promotores in the Hispanic Community

Forms and Documents

Document Name	Status
Form 3 Client Group (qualitative In-depth interview) Form and Instruction	Modified
Form 2 Client Group (pre-test, post-test, second post-tests for experimental and control groups) Form and Instruction	Modified
Form 2 Promotores (client pre-test, post-test, and second post-tests for experimenta and control groups) Form and Instruction	Modified
Form 1 Promotores (training pre-test, post-test, and qualitative in-depth interview post client session) Form and Instruction	Modified
NKDEP Supporting Statement B Final 9-12 EN.docx Supporting Statement B	2013-11-18
Attachment 7 Biographical Sketch.docx Supplementary Document	2013-11-15
Attachment 6 Applicability of the Privacy Act.docx Supplementary Document	2013-11-15
Attachment 5 Client Informed Consent.docx Supplementary Document	2013-11-15
Attachment 5 Client Informed Consent_SPA.DOCX Supplementary Document	2013-11-15
Attachment 4 Client In-depth Interview Guide_SPA.docx Supplementary Document	2013-11-15
Attachment 3 Client Pre-test and Post-test Survey_SPA.DOCX Supplementary Document	2013-11-15
Attachment 2 Promotores In-depth Interview Guide_SPA.DOCX Supplementary Document	2013-11-15
Attachment 1 Promotores Training Pre-test and Post-test Survey SPA.docx Supplementary Document	2013-11-15
NKDEP Supporting Statement A Final 9-12EN.docx Supporting Statement A	2013-11-15

IC Document Collections

IC ID	Document Title	Status
208916	Client Group (qualitative In-depth interview) Form and Instruction	Modified
208915	Client Group (pre-test, post-test, second post-tests for experimental and control groups) Form and Instruction	Modified
208914	Promotores (client pre-test, post-test, and second post-tests for experimenta and control groups) Form and Instruction	Modified
208913	Promotores (training pre-test, post-test, and qualitative in-depth interview post client session) Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0688	ICR Reference No: 201311-0925-003
Status: Historical Active	Previous ICR Reference No: 201310-0925-001
Agency/Subagency: HHS/NIH	Agency Tracking No: 20968
Title: Evaluation of a Kidney Disease Education Program with Promotores in the Hispanic Community
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 without change	Conclusion Date: 12/31/2013
	Date Received in OIRA: 11/20/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	06/30/2015
Responses	441	0	0
Time Burden (Hours)	101	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Kidney Disease Education Program (NKDEP) of the National Institutes of Health is evaluating a community kidney disease education program developed for promotores (community health workers) who teach Hispanics about diabetes care. Data for a pilot project and national dissemination of the materials will be collected through pretest and posttest surveys and in-depth interviews to finalize the draft educational and training materials and to assess the partiicipants' change in knowledge and awareness and reported behavior and health status. Without this information, NKDEP risks the possibility of inefficiently and ineffectively implementing its program with untested materials when disseminated nationally.

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Authorizing Statute(s): US Code: 42 USC 285c3 Name of Law: National Institute of Diabetes and Digestive and Kidney Diseases
  

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:
	78 FR 43214	07/19/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 59706	09/27/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Promotores (client pre-test, post-test, and second post-tests for experimenta and control groups)	2	Client pre-test, pot-test, and second post-tests for experimental control groups
Promotores (training pre-test, post-test, and qualitative in-depth interview post client session)	1	Training pre-test post-test
Client Group (pre-test, post-test, second post-tests for experimental and control groups)	2	Client pre-test, pot-test, and second post-tests for experimental control group
Client Group (qualitative In-depth interview)	3	In-depth Interview

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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	441	0	0	441	0	0
Annual Time Burden (Hours)	101	0	0	101	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 ICR.

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Annual Cost to Federal Government: $30,000

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]? No

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: 11/20/2013

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