Notice2023-20009
Agency Information Collection Activities: Proposed Collection; Comment Request
Primary source
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Published
September 15, 2023
Issuing agencies
Health and Human Services DepartmentSubstance Abuse and Mental Health Services Administration
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<title>Federal Register, Volume 88 Issue 178 (Friday, September 15, 2023)</title>
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[Federal Register Volume 88, Number 178 (Friday, September 15, 2023)]
[Notices]
[Pages 63593-63596]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-20009]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
In compliance with section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995 concerning opportunity for public comment on proposed
collections of information, the Substance Abuse and Mental Health
Services Administration (SAMHSA) will publish periodic summaries of
proposed projects. To request more information on the proposed projects
or to obtain a copy of the information collection plans, call the
SAMHSA Reports Clearance Officer on (240) 276-0361.
Comments are invited on: (a) whether the proposed collections of
information are 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.
Project: GLS State/Tribal Evaluation of the Garrett Lee Smith (GLS)
State/Tribal Youth Suicide Prevention and Early Intervention Program--
Reinstatement
The Substance Abuse and Mental Health Services Administration
(SAMHSA) Center for Mental Health Services (CMHS) is requesting
clearance for the reinstatement of data collection associated with the
previously approved evaluation of the Garrett Lee Smith (GLS) Youth
Suicide Prevention and Early Intervention Program (GLS Suicide
Prevention Program). The GLS State/Tribal Evaluation is a proposed
redesign of the currently approved evaluation (OMB No. 0930-0286;
Expiration, March 31, 2019) that builds on prior published GLS
evaluation proximal and distal outcomes and aggregate findings from
program activities (e.g., Condron, Godoy-Garraza, Walrath, McKeon, &
Heilbron, 2014; Walrath, Godoy-Garraza, Reid, Goldston, & McKeon, 2015;
Godoy-Garraza, Walrath, Kuiper, Goldston, & McKeon, 2018; Condron,
Godoy-Garraza, Kuiper, Sukumar, Walrath, & McKeon, 2018; Godoy-Garraza,
Kuiper, Goldston, McKeon, & Walrath, 2019; Godoy-Garraza, Kuiper,
Cross, Hicks, & Walrath, 2020; Goldston & Walrath, 2023). As a result
of the vast body of information collected and analyzed through the
previous cross-site evaluation SAMHSA has identified areas for
additional investigation and the types of inquiry needed to move the
evaluation into its next phase.
The purpose of the GLS Suicide Prevention Program is to facilitate
a comprehensive public health approach to prevent suicide. Passed by
Congress in 2004, the Garrett Lee Smith Memorial Act (GLSMA) was the
first legislation to provide funding for States, Tribes, and
institutions of higher education to develop, improve, and evaluate
early intervention and suicide prevention programs. GLSMA mandates that
the effectiveness of the GLS Suicide Prevention Program be evaluated
through both cross-site and local evaluation and reported to Congress.
The GLS State/Tribal Evaluation is designed to gather detailed
outcome and impact data to provide SAMHSA with the data and information
needed to understand what works, why it works, and under what
conditions, relative to program activities.
The purpose of the GLS State/Tribal Evaluation is to build the
program's knowledge base by expanding on information gathered through
the prior evaluation related to the process, products, context, and
impacts of the GLS State/Tribal Program.
The GLS State/Tribal Evaluation incorporates three areas of
evaluation to provide a robust understanding of the implementation,
outcomes, and impacts of the GLS State/Tribal Program. A behavioral
health equity and cultural equity lens will be applied to each area of
evaluation to ensure a culturally specific understanding of
intervention implementation, outcomes, and impacts.
The Implementation Evaluation inventories the array of strategies
and services implemented by grantees and answers questions about the
extent to which grantees are implementing required and allowed
prevention strategies and services, including related settings,
populations, and degree of fidelity to their work plan.
The Outcome Evaluation includes three studies related to trainings,
youths' experience of services, and the continuity of care for at-risk
youths--i.e., the Training Outcomes Study; Youth Experience, Outcomes,
and Resiliency Study (Youth Study); and Continuity of Care Study. These
studies will provide a deeper examination of the effectiveness of these
strategies as they relate to the long-term gains in trainee skills to
identify and manage youths at risk for suicide; youths' perspectives,
including an assessment of how youths experience services, supports and
facets that encourage building resilience, stress tolerance, and self-
management skills; and the effectiveness of a continuum of care that
connects youths to treatment services and supports, and post-discharge
follow-up.
[[Page 63594]]
Finally, the Impact Evaluation will combine data from the
Implementation and Outcome Evaluations to assess the effectiveness of
the GLS State/Tribal Program on decreasing suicide morbidity and
mortality. Through implementation of this evaluation design, it will be
possible to isolate prevention strategy impacts and explain cross-
program impacts on short-term (e.g., change in self-efficacy to
identify change in the number of youths identified as at risk) and
long-term program outcomes such as suicide attempts and deaths by
suicide.
Nine data collection activities compose the GLS State/Tribal
Evaluation--4 revised data collection instruments and 5 new data
collection instruments.
Instrument Removals
The current GLS State/Tribal Evaluation does not include data
collection with campus grantees, so all campus-specific instruments are
being removed. Additionally, due to SAMHSA's current research
priorities and the fulfillment of previous data collection
requirements, 7 previously approved instruments are being revised or
removed from the evaluation. These include: Behavioral Health Provider
Survey (BHPS), Prevention Strategies Inventory (PSI) Campus, Student
Behavioral Health Form (SBHF), Treatment as Prevention (TASP) Campus,
Early Identification, Referral, Follow-up, and Treatment Individual
Form, Early Identification, Referral, Follow-up, and Treatment
Screening Form, Sustainability One-Year Follow-up (SFUP), SFUP Consent-
to-Contact, and Training Utilization and Preservation--Survey (TUP-S)
Campus.
Instrument Revisions
[ssquf] PSI: the PSI is a web-based survey that captures all State/
Tribal program prevention strategies and products. Data include
strategy types and products distributed, intended audiences or
populations of focus, and expenditures across major categories (e.g.,
outreach and awareness, gatekeeper training, screening programs). Each
major strategy includes sub-strategies, enabling grantees to specify
and provide details about the sub-strategy, including implementation
setting/location, timeframe, and intended audiences or populations of
focus. The PSI is completed by grantee staff each quarter. PSI data
will inform the Training Outcomes Study and Continuity of Care Study.
Compared to the prior version of the PSI, the revised PSI includes all
previous strategies and integrates new or revised questions related to
the following areas of interest: (1) grantees use of emerging
technologies (2) implementation of evidence based practices (EBPs), (3)
cultural adaptations and health equity practices, and (4) program
sustainability. In addition, we have revised the PSI to optimize the
assessment of implementation timeframe and location and the alignment
of audiences more precisely with grantee strategies implemented.
[ssquf] TASP: the TASP is a web-based survey collecting aggregate-
level training data from all State/Tribal grantees. Data include
information about the type of training delivered, the number and roles
of training participants, and the setting of the training, including
ZIP code where the training is held (for use in analysis of GLS program
impact). The TASP also assesses intended outcomes, as well as the
number of online trainings completed, train-the-trainer events held,
and booster trainings that follow the initial training. The TASP also
gathers information about the inclusion of behavioral rehearsal or
role-play and resources provided at the training as these elements have
been found to improve retention of knowledge and skills post-training.
Additionally, the TASP collects information about resources or
materials provided to trainees (e.g., mobile or online tools or
applications for suicide prevention, fact or resource sheets, and
wallet card information) to improve understanding of how skills can be
maintained over time with materials provided at trainings (Cross et
al., 2011). A TASP is completed by grantee program staff within 2 weeks
of each in-person training activity and quarterly for virtual training
activities. The revised TASP includes more refined assessment of
training format including (1) in person; (2) virtual (facilitated on a
specific date) and (3) virtual (self-directed; trainee completes
training at own pace) and revisions to align with updated Government
Performance and Results Act (GPRA) indicators.
[ssquf] EIRFT-I: the web-based EIRFT-I gathers existing data for
each at-risk youth identified as a result of the GLS Suicide Prevention
Program (via a GLS-trained gatekeeper, a GLS-sponsored screening
identification, or via a discharge from an emergency room or inpatient
psychiatric treatment). Initial follow-up information (whether a
service was received after referral or not) is obtained along with
details on all services received in the 6 months following
identification. Ensuring adequate resources and services for referral
to care is a best practice for both screenings and gatekeeper
trainings. In addition, a response system that ensures timely referrals
is part of GLS grant requirements. Data can be extracted from case
records or other existing data sources, including any organizational
staff, community members, or family members who make a mental health
identification and referral. Respondents include grant program staff
and service providers representing all grantees in all funding years.
Data collection is ongoing for each youth identified at risk, screened
positive, or discharged from an emergency room or hospital for a
suicide attempt and/or suicidal ideation. No personal identifiers are
requested on the EIRFT-I. Grantee program staff enter EIRF-I data on an
ongoing basis. EIRFT-I data will inform the Training Outcomes and
Continuity of Care Studies. This instrument builds upon the previous
EIRF-I, with the addition of data collection on follow-up post-
discharge from emergency departments or psychiatric hospitalization and
additional information on treatment.
[ssquf] EIRFT-S: the web-based EIRFT-S gathers aggregate
information about all screening activities conducted as part of the GLS
program. Data include aggregate information on the number of youths
screened for suicide risk through the GLS program, and the number
screening positive. On an ongoing basis, the grantee will submit EIRFT-
S forms. EIRFT-S forms are completed once per implementation of a
screening tool in a group setting, once per month for clinical
screenings, and once per month for one-on-one screenings. For each
screening event in which multiple youths are screened at a given time,
one EIRFT-S should be completed for the event. For one-on-one
screenings in a clinical or other setting, one aggregated EIRFT-S is
completed per month to reflect screening outcomes of all youths
screened during the month. Grantees develop systems locally to gather
identification and referral data, including extracting data from
existing electronic health records or forms. No personal identifiers
are requested on the EIRFT-S. EIRFT-S data will inform the Continuity
of Care Study. This instrument continues the previous EIRF-S.
Instrument Additions
Five instruments will augment the evaluation.
[ssquf] TSA-P: the Training Skills Assessment-Post Training (TSA-P)
is a web-based survey to assess trainee confidence in identifying and
managing youth at risk for suicide after participation in a training
event. At the conclusion of all training events,
[[Page 63595]]
trainees will be asked to complete the TSA-P. The instrument is
designed to assess baseline confidence following the training,
knowledge of suicide prevention, confidence in identifying and managing
suicidal youth, and pretraining behaviors related to identifying and
managing youths at risk of suicide. As part of the TSA-P, trainees will
be asked to complete a consent-to-contact web form indicating their
willingness to be contacted by the GLS State/Tribal Evaluation team to
participate in the TSA-F and TSA-PS. If a trainer is unable to
administer the survey or consent-to-contact form electronically, or a
trainee does not have access to a mobile device or computer, they may
also complete the survey and consent-to-contact form on paper. The
grantee will submit this information to ICF, through direct data entry
into the Suicide Prevention Data Center (SPDC), within 2 weeks of the
training event. Once consent to contact has been received, ICF will
create a random sample of participants for the phone simulation and the
6- and 12-month follow-up surveys. TSA-P data will inform the Training
Outcomes Study.
[ssquf] TSA-F: The Training Skills Assessment-Follow up (TSA-F) is
a follow-up web-based survey to assess trainees' sustained confidence
and skills in identifying and managing youth at risk for suicide, as
well as experience with managing at-risk youth since training
(interventions with youths, additional training, etc.). The survey will
be administered to a sample of training participants at 6- and 12-
months after the initial TSA-P is completed. TSA-F data will inform the
Training Outcomes Study.
[ssquf] TSA-PS: The Training Skills Assessment-Phone Simulation
(TSA-PS) is a follow-up phone simulation using standardized interaction
to assess trainee skills in identification and management of a youth in
suicidal crisis. A random subsample of training participants will be
contacted by the evaluation team to participate in a simulated
conversation with a youth in suicidal crisis portrayed by a trained
actor. These simulations will occur between 3 and 6 months following
their initial training. The simulated conversation between the training
participant and actor will last approximately 10 to 30 minutes
(community gatekeeper sessions will likely be shorter than the
clinician interactions). In total, the session will be scheduled for 45
minutes to allow for consent, instructions, and a debrief. These phone
sessions will be administered via tele video and recorded for
additional post-simulation scoring and analysis. All sessions will be
attended by the training participant, an actor, and an evaluation team
member (observer), who will be responsible for facilitating the
interaction, administering the consent, scoring the interaction (both
in real time and based on the recording), and providing a short debrief
to the training participant. TSA-PS data will inform the Training
Outcomes Study.
[ssquf] YORS: the Youth Outcomes and Resiliency Survey (YORS) is a
web-based survey assessing the experience and outcomes of those youth
who are served by the GLS Program. The instrument is designed to assess
suicidality, positive youth development, satisfaction with services
received, youth engagement experience, and family and school dynamics.
Youth between the ages of 14-24 years who receive a positive screening
result (as part of the GLS program activities) and receive a referral
to a mental health service, or youths who attend skills-based training
will be considered eligible for the study. A sample of eligible youth
will be enrolled in the Youth Study. The age of the youth respondent
will dictate how consent is obtained for the YORS. All youths under the
age of 18 at selected grantee sites will be asked to have their parent
complete consent-to-contact forms and participate in the YORS and Youth
Experience Reflective (YER) Journal when they consent to receiving
screening from the grantee. Youths over the age of 18 will be asked to
complete consent-to-contact forms at the time of initial referral and
screening (after gatekeeper identification). The YORS will be
administered at 3-, 6-, and 12-months post enrollment, with enrollment
occurring no later than 1 month following referral to a behavioral
health service.
[ssquf] YER Journal: the YER Journal is a web-based survey
consisting of a weekly journal prompt that youth can respond to with a
photo and corresponding narrative interpretation of the photo. For
example, youths may be asked to reflect on a recent experience
receiving services. The youth would be asked to submit a photo that
represents that experience, followed by a prompt that asks: ``What
words come to mind? How did it make you feel?'' The narrative
description of what the photo represents will be analyzed using
qualitative methodologies. Up to 25 youths will be recruited to
participate in the YER Journal each year. Youths participating in the
YORS will be invited to join the YER Journal via contact through the
YORS data collection activities. For example, a youth may complete
their third quarterly YORS follow-up, and be invited to join the YER
Journal study simultaneously. Our team will leverage innovative data
collection technology to engage youth. Weekly prompts will be sent to
youths for 6 weeks post enrollment to discover, for example, which
components of what youths are receiving are meaningful and helpful, and
how youths may be utilizing skills or services following the initial
screening, both in the short and long terms.
The estimated response burden to collect this information
associated with the redesigned GLS State/Tribal Evaluation is as
follows annualized over the requested 3-year clearance period is
presented below:
Total and Annualized Averages--Respondents, Responses and Hours
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Responses Total Burden per Annual
Type of respondent Instrument Number of per number of response burden Hourly wage Total cost
respondents respondent responses (hours) (hours) rate ($) ($)
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Project Evaluator................... PSI.................... 31 4 124 1.25 155 \1\ 37.11 $5,752
Project Evaluator................... TASP................... 31 10 310 0.25 78 37.11 2,876
Project Evaluator................... EIRFT-Individual Form.. 31 4 124 2 248 37.11 9,203
Project Evaluator................... EIRFT-Screening Form... 31 4 124 0.75 93 37.11 3,451
Provider Trainee.................... TSA Consent to Contact. 10,000 1 10,000 0.08 800 27.46 21,968
Provider Trainee.................... TSA-P.................. 10,000 1 10,000 0.3 3000 27.46 82,380
Provider Trainee.................... TSA 6-month............ 187 1 187 0.3 56 27.46 1,541
Provider Trainee.................... TSA 12-month........... 140 1 140 0.3 42 27.46 1,153
Provider Trainee.................... TSA-PS................. 101 1 101 0.75 76 27.46 2,080
Youth............................... YORS baseline.......... 300 1 300 0.5 150 7.25 1,088
Youth............................... YORS 3-month........... 240 1 240 0.5 120 7.25 870
Youth............................... YORS 6-month........... 192 1 192 0.5 96 7.25 696
Youth............................... YORS 12-month.......... 115 1 115 0.5 58 7.25 417
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Youth............................... YER Journal............ 25 6 150 0.25 38 7.25 272
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Total........................... ....................... 21,424 ........... 22,107 ........... 5,008 ........... 133,747
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* Rounded to the nearest whole number.
Send comments to Carlos Graham, SAMHSA Reports Clearance Officer,
<a href="/cdn-cgi/l/email-protection#d4b7b5a6b8bba7fab3a6b5bcb5b994a7b5b9bca7b5fabcbca7fab3bba2"><span class="__cf_email__" data-cfemail="690a081b05061a470e1b08010804291a0804011a084701011a470e061f">[email protected]</span></a>. Written comments should be received by
November 14, 2023.
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\1\ BLS OES May 2022 National Industry-Specific Occupation
Employment and Wage Estimates average annual salary for Survey
Researchers (code 19-3022); <a href="https://www.bls.gov/oes/current/naics5_541720.htm">https://www.bls.gov/oes/current/naics5_541720.htm</a>.
Alicia Broadus,
Public Health Advisor.
[FR Doc. 2023-20009 Filed 9-14-23; 8:45 am]
BILLING CODE 4162-20-P
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