Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2019 Updated B Reader Certification Examination New 50 200 0 Other-WORD
Other-Screenshots
Antibiotic Stewardship in Hospitals Assessment New 80 70 9000 Form none Hospital Antibiotic Stewardship Core Element Assessment
Form none Feedback Questionnaire
Assessment of the Zika Care Connect Program New 4080 260 0 Form and Instruction 0920-1154 Invitation Email to access Survey - Health Care Professional
Form and Instruction 0920-1154 Reminder Invitation Email to access Survey - Health Care Professional
Form and Instruction 0920-1154 Survey - Healthcare Professional
Form and Instruction 0920-1154 Pop-Up Invitation to Survey - Website User
Form and Instruction 0920-1154 Survey - Website User
BRFSS Feasibility Experiment for State-specific Module Data Collection in Cell Phone Samples New 4500 1500 0 Form and Instruction 0920-1154 Questionnaire Content
BRFSS Preliminary Experiment for Sample and Mode New 13500 3375 0 Other-WORD
Behavioral Determinants of Community Hand Hygiene Behavior: A Formative Qualitative Evaluation New 520 113 0 Form 0920-1154 Online Screener
Form and Instruction 0920-1154 Focus Group Moderator Guide
CDC's Inside Knowledge Campaign: 2018 Focus Group Research and Testing with the General Public and Hispanic Audiences New 576 720 18821 Form and Instruction n/a English Language Screening Instrument
Form and Instruction n/a Spanish Language Screening Instrument
Form and Instruction n/a English Language Focus Group Discussion Guide
Form and Instruction n/a Spanish Language Focus Group Discussion Guide
Clinician Preferences for CDC Clinical Guidelines New 25 25 0 Other-WORD
Other-WORD
Core Elements of Antimicrobial Stewardship in Nursing Homes New 992 496 0 Form none Prescriber Assessment
Determination of Attitudes Regarding Noise in Construction New 68 82 2269 Form and Instruction 0920-1154 Construction Industry Executive/Decision-Maker In-Depth Interviews
Form and Instruction 0920-1154 Construction Supervisor/Foreman Focus Group
Form and Instruction 0920-1154 Construction Workers Focus Groups (ENGLISH)
Form and Instruction 0920-1154 Construction Workers Focus Groups (SPANISH)
Disability and Health Data System Evaluaton Survey New 2000 167 0 Form and Instruction 0920-1154 Disability and Halth Data System Evaulation Survey
Ethnicity & Race: Messaging to Improve Patient-Provider Communication and Engagement on Risks of Alcohol Use During Pregnancy New 900 307 0 Form and Instruction 0920-1154 Consent Form Provider (Online Survey)
Form and Instruction 0920-1154 Consent Form Provider In-Depth Interview
Form and Instruction 0920-1154 Consent Form Women In-Depth Interview
Form 0920-1154 Provider Screener and Online Survey
Other-Screenshots
Other-WORD
Instruction
Other-WORD
Other-Screenshots
Other-Screenshots
FORMATIVE RESEARCH TO DEVELOP ZIKA TOOLS FOR HEALTHCARE PROVIDERS New 4422 835 0 Form 0920-1154 ACOG Zika Virus Survey
Other-Focus Group Discussion Guide - OB-GYN/PEDS/MIDWIVES/NPs
Form and Instruction 0920-1154 Focus Group Recruitment Screen
Form and Instruction 0920-1154 ACOG Evaluation of Local Health Department Initiative
Federal Select Agent Program eFSAP Feedback Survey New 528 88 0 Form 0920-1154 FSAP Survey System Enhancement
Form 0920-1154 FSAP User Experience Survey
Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention New 804 157 0 Form and Instruction none Recruitment Screener
Form and Instruction none Recruitment Follow-up Contact
Other-Moderator Guide
Other-Moderator Guide with Interview
Formative Assessment of Barriers to Transition from Adolescent to Adult for Individuals with Congenital Heart Defects New 1100 367 0 Form none Survey of Parents of Adolescents with Congenital Heart Defects
Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers New 28 42 0 Other-Focus Group Guide
Formative Assessment of the Information Needs to Prevent Work-related Musculoskeletal Disorders and Falls among Aging Retail Workers New 54 81 0 Other-Focus group guide
Other-Focus group guide
Other-Focus group guide
Formative Evaluation for Shigellosis Sexual Health Materials for Men who have Sex with Men New 445 79 0 Form none Screener
Other-Moderator's Guide
Formative Research for Sepsis and Antibiotic Use Campaigns New 750 208 0 Form none Sepsis Consumer Screener - mothers
Form none Sepsis Consumer Screener - healthy adults 65+
Form none Sepsis Consumer Screener - AA men
Form none HCP Sepsis Screener - ED triage nurse
Form none HCP Sepsis Screener - NP or PA
Form none HCP Sepsis Screener - PCP
Form none HCP Sepsis Screener - Gen med ward
Form none Consumer Interview Sepsis
Form none HCP Interview Sepsis
Form none HCP Antibiotic Use Screener
Form none Consumer Screener - SD-SE
Form none Consumer Screener - CD - CE
Form none HCP Antibiotic Use Interview
Form none Consumer Interview - SE - SD
Form none Consumer Interview - CE - CD
Other-Focus Group Guide
Other-Focus Group Guide
Other-Focus Group Guide
Other-Focus Group Guide
Formative Research to Assess Pediatric Healthcare Providers Knowledge, Attitudes and Practices around Zika Virus New 1600 533 0 Form none Survey of Experiences with and Attitudes towards Zika Virus
Formative Research to Develop an Open Data Standard for Reporting Environmental Health Data New 43 43 0 Form and Instruction 0920-1154 Key Informant Interview Plan
Formative Research to Identify Common and Unique Barriers to the Exchange of Hospitalization and ED Data New 52 113 0 Form none Survey
Form none Survey - word
Form none Survey prenotice
Formative Research to Inform an Intervention to Improve Early Detection and Surveillance of Pneumoconiosis in US Coal Miners New 276 124 0 Other-Interview guide
Form none Interview demographic survey
Other-Focus group guide
Form none Focus group demographic survey
Form none Interview sign-up
Formative Research with Clinicians for the Development of Quantitative Metrics to Improve Antibiotic Prescribing Behavior in the Outpatient Setting New 24 24 0 Other-WORD
Increase Enrollment in the CDC-Recognized Lifestyle Change Program (LCP) New 768 168 0 Form and Instruction NA Pre-Session Survey
Form and Instruction NA Post-Session Survey
Form and Instruction NA Enrollment Materials and Referral Tracking Form
Form and Instruction NA LCP Staff/Coach Interview Guide
Older Adult Mobility Ride Share (OAMRS) New 535 190 9786 Form and Instruction 0920-1154 Written Questionnaire Focus Group
Form and Instruction 0920-1154 Focus Group Protocol - Users
Form and Instruction 0920-1154 Focus Group Protocol - Non-Users
Form and Instruction 0920-1154 Interview Protocol - Users
Form and Instruction 0920-1154 Interview Protocol - Non-Users
Form and Instruction 0920-1154 Screener Focus Group
Form and Instruction 0920-1154 Screener Telephone Interview
Participatory Mapping to Identify and Support At-Risk Populations in Emergency Preparedness – Phase 3 New 40 20 0 Form and Instruction 0920-1154 Survey Disaster Planners
Participatory Mapping to Identify and Support at-Risk Populations in Emergency Preparedness New 100 100 0 Other-Interview Guide
Participatory Mapping to Identy and Support at Risk Population in Emergency Preparedness -- Phase 2 New 75 150 0 Other-WORD
Persuasive Communication about Risks from and Responses to Zika – State, Local and Tribal Government Interviews New 30 23 0 Form and Instruction NA Interview Guide - Public Health Officials
Persuasive Communication about Risks from and Responses to Zika: FOCUS GROUPS New 72 216 0 Form and Instruction NA Focus Group - Vignette
Reaching Minority Men Where They Are – Formative Research to Build Capacity for Enrollment in Diabetes Prevention and Management Programs New 4048 447 10877 Form and Instruction n/a Focus Group Guide: Minority Men at Risk for Type 2 Diabetes
Form and Instruction n/a Focus Group Guide: Minority Men Diagnosed with Type 2 Diabetes
Form and Instruction n/a Screener
Form and Instruction n/a Initial Screen Shot of the Web-based Survey (with OMB control information)
Form and Instruction n/a Survey (content)
Reframing How We Talk About Alcohol New 354 132 0 Form and Instruction none Screener
Other-Moderator Guide
Other-Moderator Guide
Zika Family Survey: In-Depth Interviews with Women Affected by Zika Virus New 260 85 0 Instruction
Instruction
Form and Instruction 0920-1154 IN-DEPTH INTERVIEWS WITH WOMEN AFFECTED BY THE ZIKA VIRUS - INTERVIEW GUIDE
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 43699 11540 50753  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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