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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:
0920-0840
ICR Reference No:
202103-0920-001
Status:
Historical Active
Previous ICR Reference No:
201808-0920-023
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0840
Title:
Formative Research and Tool Development
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
07/13/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/08/2021
Terms of Clearance:
Previous terms continue: OMB approves this umbrella generic, and has informed CDC that each individual study should be submitted into ROCIS an a genIC that includes the actual study instruments and a memo describing the specific study goal, the study design, any incentives to be used, and the sampling and analysis plans.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2024
36 Months From Approved
10/31/2021
Responses
121,800
0
121,800
Time Burden (Hours)
46,516
0
46,516
Cost Burden (Dollars)
2,348,936
0
2,348,936
Abstract:
The CDC NCHHSTP has greatly benefitted from this Formative Research and Tools Development Generic Information Collection, OMB #0920-0840. Since receiving the 2018 OMB approval, 7 generic information collection requests (ICRs) have been approved under the Formative Research and Tool Development Generic Clearance (Attachment 10). With this information collection, CDC has conducted formative research to inform the development of and refinement of our HIV prevention messages, collect information on student and teacher perspectives on sexual health and issues related to sexual health and men who have sex with men (MSM). For example, CDC has been able to developed and tested materials to examine jail and prison policies to reduce STD rates. Under this mechanism, CDC has developed a mobile message intervention for MSM with the purpose of using formative research to develop and assess HIV prevention messages tailored for men who have sex with men (MSM) in the United States, including informational and motivational messages about recent advances in biomedical HIV prevention.. This Generic gives CDC the opportunity to obtain qualitative feedback that we need to be able to develop and adapt our campaigns, which are vital to the CDC/NCHHSTP mission in a timely manner.
Authorizing Statute(s):
US Code:
42 USC 241
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:
86 FR 9346
02/12/2021
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 26515
05/14/2021
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
DASH COVID-19 Demonstration: Mental Health Formative Evaluation and Pilot Study
0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840
School Administrators - Key Informant Interview
,
District MTSS Team Members - Key Informant Interview
,
Middle/High School Students - Student Focus Groups
,
School MTS Team Members - School Implementation Checklist
,
District MTSS Team Members - District Implementation Checklist
,
School MTSS Team Members - MTSS School Level Focus Group
DASH COVID-19 School Connectedness Formative Evaluation - Pilot Study
0920-22IF, 0920-22IF, 0920-22IF, 0920-22IF
Att2 SC Demo_KII Interview Guide
,
Att3 SC Demo_Champion Focus Group Guide
,
Att4 SC Demo_Teacher Focus Group Guide
,
Att5 SC Demo_Student Focus Group Guide
DASH DEMO: Comprehensive Health Educator Core Knowledge and Skills (CHECKS) Professional Development (PD) Pilot Study
0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840
#1 Webinar- Adolescent Growth and Development
,
#2 Webinar- Assess and Adjust:
,
#3 E-learning module survey- Basic Principles of Teaching Health Education
,
#2 E-learning module survey- Culturally Responsive Health Education Classroom
,
In-person training evaluation
,
Micro Session Survey
,
#1 E-learning module survey- Trauma informed approach
,
Teacher Survey
,
Student Survey
DASH DEMO: LGBTQ Inclusivity Toolkit Evaluation
0920-0840, 0920-0840, 0920-0840, 0920-0840
Pre-Post School Staff Survey Monkey
,
LGBTQ Inclusivity Toolkit Demonstration Project Monthly Report Form
,
LGBTQ Inclusivity Toolkit Demonstration Project Post-Pilot Feedback Interview Guide
,
Pre=Post School Staff Survey
[NCHHSTP] DASH DEMO: LGBTQ Inclusivity Toolkit Evaluation 2022-2024
n/a, n/a, n/a, n/a, n/a
Climate Interview Consent and Guide
,
School Staff Survey – Pre & Post Toolkit
,
Monthly Report Form
,
Post-Pilot Feedback Interview Guide
,
School Staff Survey – Pre & Post Toolkit (Word)
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
121,800
121,800
0
0
0
0
Annual Time Burden (Hours)
46,516
46,516
0
0
0
0
Annual Cost Burden (Dollars)
2,348,936
2,348,936
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:
$574,500
Does this IC contain surveys, censuses, or employ statistical methods?
No
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.
No
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.
No
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?
No
Agency Contact:
Thelma Sims 4046394771
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:
06/08/2021
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