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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 Generic ICR - OIRA Conclusion
OMB Control No:
0920-0222
ICR Reference No:
201807-0920-004
Status:
Historical Active
Previous ICR Reference No:
201506-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0222
Title:
Collaborating Center for Questionnaire Design and Evaluation Research
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
08/31/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/27/2018
Terms of Clearance:
CDC will continue to submit individual collections under this generic clearance to OMB. OMB will strive to provide feedback on the individual collections within ten working days, whenever possible, as is currently the case. Standard remuneration of respondents for cognitive testing ($40) and focus groups ($75) applies until research is presented suggesting these rates should be changed or in situation where evidence already exists that a particular subpopulation requires a higher incentive.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2021
36 Months From Approved
08/31/2018
Responses
56,100
0
24,000
Time Burden (Hours)
23,350
0
13,150
Cost Burden (Dollars)
0
0
0
Abstract:
This generic clearance request encompasses general questionnaire development, pre-testing, measurement-error reduction activities to be carried out in 2018-2021 in the Division of Research and Methodology, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). The revision requested consists of an increase in burden hours for the next 3-year approval period. The difference is due to an anticipated increase in the number and size of projects being undertaken.
Authorizing Statute(s):
US Code:
42 USC 242k
Name of Law: Public Health Service Act
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:
83 FR 8875
03/01/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 35646
07/27/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
23
IC Title
Form No.
Form Name
Cannabis Questions
0920-21GG, 0920-21GG, 0920-21GG, 0920-21GG, 0920-21GG
Screener
,
Question Provenance
,
Questionnaire
,
Data Collection Sheet
,
Follow Up Interview
Cognitive Interview Study: Spanish-language Telephone-administered Questions for PRAMS (2019)
n/a, n/a, n/a
Telephone Screening Script (in Spansih)
,
PRAMS 2019 questions to be cognitively tested (Phone/Spanish version)
,
Respondent Data Sheet (in Spanish)
Cognitive Test for ACS Disability Questions and NHIS Child Behavior Questions
n/a, n/a, n/a
Telephone Screener
,
ACS Booklet and Selected NHIS Questions Discussed During the Cognitive Interview
,
Respondent Data Collection Sheet (Demographics)
Cognitive Test for NHIS Questions and Opiods
0920-0222, 0920-0222, 0920-0222
Questions to be Cognitively Tested
,
Screeners
,
Respondent Data Collection Sheet
Cognitive Test for the Pregnancy Risk Assessment Monitoring System (PRAMS)
0920-0222, 0920-0222, 0920-0222
2019 Questions for Cognitive Testing
,
Screener
,
Respondent Data
Cognitive Testing for American Community Survey
none, none, none
Telephone screeners
,
Interview instrument
,
Respondent data collection sheets
Cognitive Testing of 2021 Occupational Health Supplement Questions
0920-0222, 0920-0222
Questions for Consideration NHIS-OHS 2021 Supplement
,
Respondent Data Collection Sheet
Cognitive Testing of Adverse Childhood Events Questions for the Youth Risk Behavior Surveillance System (YRBSS)
0920-0222, 0920-0222, 0920-0222, 0920-0222, 0920-0222
Respondent Screener
,
Screener Parent/Guardian
,
Questionnaire - uestions to be Cognitively tested
,
Respondent Data Collection Sheets - In-person/Virtual
,
Respondent Debriefing Interview
Cognitive Testing of Occupational Safety and Health Questions for the Youth Risk Behavior Surveillance System (YRBSS) [with incentive level test]
n/a, n/a, n/a, n/a, n/a
Telephone Screening Script (for Target Respondents)
,
Telephone Screening Script (for Parent / Guardian)
,
Questions to be Cognitively Tested
,
Respondent Data Collection Sheet
,
Follow-up Debriefing Discussion
Cognitive Testing of Physician Opioid Questions
none, none
National Survey on Best Practices for Patient Pain Management and Opioid Use
,
Respondent data collection sheet
Cognitive Testing of Questions on Complementary Health Approaches and Well-being
n/a, n/a, n/a
Telephone Screener
,
NHIS Complementary Health Approaches and Well-being Questionnaire
,
Respondent Data Collection Sheet [demographics]
NCHS Research and Development Survey (RANDS)
0920-0222
Web Questionnaire Introduction Screen and RANDS Questionnaire
NIOSH Virtual Cognitive Interview Study
none, none, none
Telephone screener
,
NIOSH questionnaire
,
Respondent data sheet
NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)
NSFG Life History Calendar Evaluation
0920-0222, 0920-0222, 0920-0222, 0920-0222, 0920-0222
Attachment 1a: Questions to be cognitively tested
,
Attachment 1b - Life History Calendar Worksheet (Recall Aide)
,
Attachment 3a – Telephone Screening Script – Respondent recruited from newspaper advertisement/flyer
,
Attachment 3b – Telephone Screening Script – Respondent recruited from CCQDER Respondent Database
,
Attachment 5: Respondent Data Collection Sheet
NSFG Testing
0920-21EC, 0920-21EC, 0920-21EC, 1
Telephone Screener
,
Virtual Interviews Data collection Sheet
,
Respondent Debriefing
,
Test Questions
National Health and Nutrition Examination Survey (NHANES – Growth Chart)
n/a, n/a
Focus Group Protocol (NHANES Growth Chart)
,
Data Collection Sheet (participant demographics)
PRAMS Opioid 2018 - English
none, none, none
PRAMS Opioid 2018
,
Telephone Screener
,
Respondent Data Sheet
PRAMS Opioid 2018 -Spanish
none, none, none
PRAMS Opioid 2018 - Spanish
,
Telephone Screener - Spanish
,
Respondent Data Collection Sheet
RANDS - NISVS
0920-0222, 0920-0222, 0920-0222, 0920-0222, 0920-0222
Questionnaire 55 minute
,
Questionnaire 20 minute
,
Telephone screener - flyer and database
,
Respondent Data Collection Sheet
,
Respondent Debriefing
RANDS NSFG
0920-0222
RANDS NSFG Web Questionnaire
The Research and Development Survey (RANDS 4 -- Telephone Sample)
Validity Study of Intellectual and Disability Questions
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
56,100
24,000
0
32,100
0
0
Annual Time Burden (Hours)
23,350
13,150
0
10,200
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:
The increase in burden is due to an anticipated increase in the number and size of projects being undertaken.
Annual Cost to Federal Government:
$2,229,740
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Kevin Joyce 404 639-1944 kdj7@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:
07/27/2018