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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:
201509-0920-013
Status:
Historical Active
Previous ICR Reference No:
201502-0920-013
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0856
Title:
National Quitline Data Warehouse
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
03/24/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/14/2015
Terms of Clearance:
Approved consistent with the understanding that data from tobacco users as gathered by this collection is limited to only those tobacco users who receive services from funded state telephone quitlines. Information gathered are thus not representative of, or generalizable to, the general US population of tobacco users, but only those who contact their state quitlines regarding cessation support services.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2019
36 Months From Approved
03/31/2016
Responses
506,656
0
564,621
Time Burden (Hours)
80,709
0
89,035
Cost Burden (Dollars)
0
0
0
Abstract:
CDC is requesting approval for Revisions to the National Quitline Data Warehouse (NQDW) Quitline Services Survey.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 4002
Name of Law: Patient Protection and Affordable Care Act PPHF
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
60-day Notice:
Federal Register Citation:
Citation Date:
80 FR 32383
06/08/2015
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 61211
10/09/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
ASQ Intake Questionnaire (Chinese, Korean, Vietnamese - Subset)
NA, NA, NA
ASQ Intake Questionnaire (Chinese - Subset)
,
ASQ Intake Questionnaire (Korean - Subset)
,
ASQ Intake Questionnaire (Vietnamese - Subset)
Asian Smokers Quitline (ASQ) Intake Questionnaire (Complete Chinese, Korean, Vietnamese)
NA, NA, NA
NQDW Intake Questionnaire - Chinese Complete
,
NQDW Intake Questionnaire - Korean Complete
,
NQDW Intake Questionnaire - Vietnamese Complete
Asian Smokers Quitline (ASQ) Seven-Month Follow-Up Questionnaire
NA, NA, NA, NA
NQDW 7-Month Follow-Up Questionnaire - English
,
NQDW 7-Month Follow-Up Questionnaire - Chinese
,
NQDW 7-Month Follow-Up Questionnaire - Korean
,
NQDW 7-Month Follow-Up Questionnaire - Vietnamese
Follow-up for Callers who Received a Quitline Service
F1
NQDW 7-Month Follow-Up Questionnaire
NQDW Intake Questionnaire (English complete) - Callers who contact Quitline for themselves
NA
NQDW Intake Questionnaire - Complete
NQDW Intake Questionnaire (English subset) - Callers who contact Quitline on behalf of someone else
NA
NQDW Intake Questionnaire - Subset
NQDW Quitline Services Survey
NA
National Quitline Data Warehouse (NQDW) Quitline Services Survey
Submission of NQDW ASQ Seven-Month Follow-Up Electronic Data File to CDC
Submission of NQDW Intake Questionnaire Electronic Data File to CDC
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
506,656
564,621
0
-57,965
0
0
Annual Time Burden (Hours)
80,709
89,035
0
-8,326
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
Modification in Burden Hours are the result of revisions made to the NQDW Questionnaire and addition of Questionnaire in additional languages.
Annual Cost to Federal Government:
$1,257,220
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]?
Yes
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:
Jeffrey Zirger 404 639-7118 wtj5@cdc.gov
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:
10/14/2015