Supporting Statement

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number:0935-0179)

TITLE OF INFORMATION COLLECTION: Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews

PURPOSE: The purpose of the stakeholder interviews shall be to elicit individual opinions, inputs, and feedback of leaders and experts representing key stakeholders in the health services research (HSR) and primary care research (PCR) funded by AHRQ. The topics to be discussed include the types of HSR and PCR funded by AHRQ compared to other federal agencies, and the impacts, overlaps, and current gaps of this research.

DESCRIPTION OF RESPONDENTS: Respondents for the interviews will include: state-level healthcare policymakers and decision-makers, researchers in HSR and PCR, healthcare delivery system leaders (i.e., C-suite leadership), and other users of HSR and PCR (e.g., consumer groups, payers/purchasers, insurers).

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [ x] Other: Qualitative interviews

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:______Jaime Zimmerman__________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ x] Yes [ ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ x] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ x] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ x] No

Category of Respondent: (the options here are Public Sector or Private Sector, or both)

Both public sector and private sector

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector	30	1.5 hours	45 hours
Public Sector (state-level stakeholders)	10	1.5 hours	15 hours
Totals	40	N/A	60 hours

On average, participants are estimated to spend: 1 hour per person for participating in the interview plus 30 minutes per person for (1) reading the project information sheet and considering whether or not to participate and (2) answering brief follow-up question(s) by phone or email.

FEDERAL COST: The estimated annual cost to the Federal government is $253,129

This includes $2,167 in Federal agency labor cost as detailed below, plus $250,962 in contracted cost.

Grade	Number of Hours	Value
GS 15-Step 5	16 hrs ($73.20)	$1,171.20
GS 14-Step 5	16 hrs ($62.23)	$995.68
Total		$2,166.88

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [ x] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

We are identifying a sampling pool of potential stakeholder interview participants from the following sources: (a) nominations from relevant stakeholder organizations, (b) lists of participants in previous technical expert panels related to HSR and PCR, (c) lists of participants in previous or current advisory panels related to HSR and PCR, and (d) the study team’s professional contacts and networks.

The stakeholder interview participants will be purposively selected from the sampling pool to include a breadth of experience and balance of perspectives across the identified stakeholder groups.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ x] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ x] Yes [ ] No