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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0856
ICR Reference No:
201203-0920-001
Status:
Historical Active
Previous ICR Reference No:
201105-0920-009
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
National Quitline Data Warehouse
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/06/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/02/2012
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2012
07/31/2012
07/31/2012
Responses
759,112
0
759,112
Time Burden (Hours)
90,563
0
90,563
Cost Burden (Dollars)
0
0
0
Abstract:
CDC will collect newly standardized information from Quitline service providers in 50 states, DC, Puerto Rico and Guam. Data about each program will be collected, as well as caller intake and follow-up data. Information will be used for program improvement and to evaluate the expenditure of funding provided by the ARRA of 2009.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 5 1
Name of Law: American Recovery and Reinvestment Act of 2009
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Follow-up for Callers who Received a Quitline Service
none
NQDW 7month follow up questionnaire
Intake Information for Callers who Contact the Quitline for Personal Use
none
NQDW intake questionnaire
Intake Information for Callers who Contact the Quitline for Someone Else
none, #1 Revised
NQDW intake questionnaire
,
National Quitline Data Warehouse Intake Questionnaire
Quitline Services Questionnaire
none
NQDW services questionnaire
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
759,112
759,112
0
0
0
0
Annual Time Burden (Hours)
90,563
90,563
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$3,125,962
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?
Yes
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)?
Yes
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Petunia Gissendaner 4046390164
Common Form ICR:
No
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:
03/02/2012
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