Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
(NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring Unchanged 264 56 0 Form and Instruction n/a Antifungal TDM Focus Group Screener
Form and Instruction n/a Antifungal TDM Focus Group Guide
Creative Concept Testing on Antimicrobial Resistance Unchanged 616 127 0 Form and Instruction 0920-1154 Focus Group Screener for Consumers, Including Parents
Form and Instruction 0920-1154 Interview Screener for Healthcare Providers
Form and Instruction 0920-1154 Focus Group Guide for Consumers about Antimicrobial Resistance Concept Testing
Form and Instruction 0920-1154 Interview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing
Feedback Survey for Community Counts Data Viz Tool Unchanged 100 5 0 Form and Instruction 0920-1154 Feedback Survey for Community Counts Data Viz Tool
Formative Research for Spanish-Language Drug Overdose Messages Unchanged 4726 447 0 Form and Instruction n/a Qualitative Eligibility Screener (Phone)
Form and Instruction n/a Qualitative Eligibility Screener (Online)
Form and Instruction n/a Focus Group Moderator Guide
Form and Instruction n/a Interview Guide
Form and Instruction n/a Online Survey
Form and Instruction n/a Respondent Consent Form and Participants Email
Instruction
Instruction
In-Depth Interviews with Healthcare Professionals about C. Diff Materials Unchanged 121 22 0 Form and Instruction 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services
Form and Instruction 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES)
Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys) Unchanged 1750 379 0 Form and Instruction 0920-1154 Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Broadcast Radio
Form and Instruction 0920-1154 Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Digital Ad
Other-Screenshots - Broadcast Radio
Other-Screenshots - Digital Ad
Instruction
[CPR] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey Unchanged 16 16 0 Form 0920-25-0125 ASEAN PHEM WLP Survey
[CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.) Unchanged 1250 2750 0 Form and Instruction 0920- 23DF Attachment B_Immediate Post Exercise Survey Questions
Form and Instruction 0920-23DF Attachment C_Follow Up Survey Questions
Form and Instruction 0920-23DA Attachment D_Focus Group Script
[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Modified 1084 334 0 Form n/a Pilot Evaluation Pre-Implementation Survey
Form n/a Pilot Evaluation POST-Implementation Survey
Form n/a Staff Focus Groups
Form n/a Leader Focus Groups
[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak Unchanged 65 111 0 Form and Instruction n/a Personal Protective Equipment Key Informant Interviews
Form and Instruction n/a Online Survey Questionnaire (to be amended as appropriate following review of KII responses)
[CPR] This is a T.E.S.T. Unchanged 2350 875 0 Form 0920-24GC Initial Survey
Form 0920-24GC Follow- up Survey
Form 0920-24GC Focus Group
[CSELS/DLS]CDC OneLab Network Formative Evaluation Unchanged 30 2 0 Form and Instruction 0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023
[NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool Unchanged 100 5 0 Form and Instruction 0920-1154 Feedback Survey for Community Counts Data Viz Tool
[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I) Unchanged 150 68 0 Form and Instruction None DSMES Provider Screener Script and Guidelines
Form and Instruction None Listening Sessions Guide for Providers Who Support People with Learning Disabilities
Form and Instruction None Listening Sessions Guide for Providers Who Support Minority Women
Form and Instruction None Listening Sessions Guide for Providers Who Support People with Mental Health Disorders
[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance Unchanged 1000 250 0 Form and Instruction 0920-1154 Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance
Form and Instruction 0920-1154 Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance
Form and Instruction 0920-1154 Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish
Form and Instruction 0920-1154 Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish
[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes Unchanged 360 69 0 Form 0920-1154 Screening/Eligibility Form for Interviews/Focus Groups (24CU)
Form and Instruction 0920-1154 Eligible Participant Screener (24CU)
Form and Instruction 0920-1154 Moderator or Interviewer Guide (24CU)
Form and Instruction 0920-1154 MESSAGES to be TESTED (24CU)
[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Unchanged 6794 650 0 Form and Instruction 0920-1154 Eligibility Screener - Focus Group
Form and Instruction 0920-1154 Eligible Participant Screener - Focus Group
Form and Instruction 0920-1154 Eligibility Screener - Survey
Form and Instruction 0920-1154 Focus Group Moderator Guide
Form and Instruction 0920-1154 Rapid Online Survey
[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses Unchanged 528 112 0 Form and Instruction n/a Focus Group Screener
Form and Instruction n/a Focus Group Consent Form
Form and Instruction n/a Focus Group Guide
[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes Unchanged 3474 522 0 Form and Instruction None Eligibility Screener for Focus Group
Form and Instruction None [Additional] Eligible Participant Screener for Focus Group
Form and Instruction None Focus Group Moderator Guide
Form and Instruction None Eligibility Screener for Rapid Survey
Form and Instruction None Rapid Survey
Other-Screenshots of the Eligibility Screener for the Rapid Survey
Other-Screenshots of the Rapid Survey
[NCEZID] Harmful Algal Blooms Communication Evaluation Unchanged 420 80 0 Form 0920-1154 Screening/Eligibility Form for Focus Groups (24CX)
Form 0920-1154 Eligible Participant Screener for Focus Group (24CX)
Instruction
Form and Instruction 0920-1154 Focus Group Moderator Guide (24CX)
[NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data Unchanged 13 7 0 Form 092061154 NHSN’s REaLI Effort
[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities Unchanged 234 63 0 Form and Instruction n/a DHQP Interview Screener
Form and Instruction n/a Interview Guide: Resident and Family/Close Friend (Paired Interview)
Form and Instruction n/a Interview Guide: Family/Close Friend (Follow-Up Interview)
[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases Unchanged 90 18 0 Form and Instruction 0920-1154 RECRUITMENT SCREENER In-Depth Interviews with Hispanic or Latina Women
Form 0920-1154 CONSENT FORM In-Depth Interviews with Hispanic or Latina Women
Form and Instruction 0920-1154 MODERATOR INTERVIEW GUIDE In-Depth Interviews with Hispanic or Latina Women
[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project Unchanged 1590 306 0 Form and Instruction n/a Recruitment Screener
Form and Instruction n/a Technology Pre-check
Form and Instruction n/a AR Formative Evaluation Interview Guide
[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Unchanged 180 83 0 Form 0920-1154 Screening/Eligibility Form for Focus Groups
Form 0920-1154 Eligible Participant Screener for Focus Group (24CP)
Other-Consent
Form and Instruction 0920-1154 Focus Group Moderator Guide (24CP)
[NCIPC] Adolescent Mental Health Journey Mapping Project Unchanged 1098 473 0 Instruction
Form and Instruction n/a Screening Survey and Parental Consent
Form and Instruction n/a LGBTQ+ Teen Screening Survey
Other-Consent/Assent Forms
Form and Instruction n/a Adolescent Interview Discussion Guide
Form and Instruction n/a Adolescent Focus Group Discussion Guide
Form and Instruction n/a Adolescent Brainstorming Session Discussion Guide
[NCIPC] Adoption Accelerator Social Network Analysis (Formative Research) Unchanged 300 95 0 Form 0920-24GZ Sheriffs’ Advice-Seeking Survey
[NCIPC] Adverse Childhood Experiences Prevention Message Development Unchanged 200 86 0 Form and Instruction 0920-1154 ACEs Survey and Consent - Revised 25MAR2025
Other-Screenshots
Form and Instruction 0920-1154 ACEs Focus Group Participant Screener - Revised 25MAR2025
Form and Instruction 0920-1154 (24IP) ACEs Focus Group Consent Form
Instruction
Form and Instruction 0920-1154 (24IP) ACEs Partner Interview Consent Form
Form and Instruction 0920-1154 (24IP) ACEs Partner Interview Guide
[NCIPC] Caring Adults Perceptions on Teen Mental Health Unchanged 10 28 0 Instruction
Form and Instruction 0920-1154 (24HL) ADULT MENTOR SCREENING SURVEY
Instruction
Form and Instruction 0920-1154 (2HL) INTERVIEW DISCUSSION GUIDE
[NCIPC] Caring Adults Perceptions on Teen Mental Health Unchanged 65 28 0 Form 0920-24HY Screening Survey
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Unchanged 145 24 0 Form and Instruction n/a Email Invitation
Form and Instruction n/a First Follow-up Email
Form and Instruction n/a Second Follow-up Email
Form and Instruction n/a Semi-Structured Interview Guide
[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Unchanged 1344 402 0 Form and Instruction n/a Firearm Injury and Death Survey and Consent
Form and Instruction n/a Firearm Injury and Death Focus Group
Form and Instruction n/a Firearm Injury and Death Focus Group Screening
Form and Instruction n/a Community Violence Survey and Consent
Form and Instruction n/a Community Violence Focus Group
Form and Instruction n/a Community Violence Focus Group Screening
[NCIPC] Screening Survey for focus groups and interviews Unchanged 64 81 0 Form 0920-1154-24CC Recruitment Materials - Focus Groups and Interviews - AI/AN Adults
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Form and Instruction 0920-1154 (24CC) Focus Group Guide AI/AN Adults
Form and Instruction 0920-1154 (24CC) Interview Guide Tribal Health Care Providers (HCPs) and Tribal Leaders
[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages Unchanged 638 256 0 Form and Instruction n/a Parent and Child Screeners
Other-Consent
Other-Consent
Form and Instruction n/a Activity Guide
[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Unchanged 602 161 0 Form 0920-24EH OHZDP Interest Intake Form
Form 0920-24EH OHZDP Baseline Survey
Form 0920-24EH OHZDP Facilitator Training Survey
Form 0920-24EH OHZDP Participant Survey
Form 0920-24EH OHZDP Next Steps Tracker
Form 0920-24EH OHZDP Post Workshop Survey
Form 0920-24EH OHZDP Retrospective Survey
[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Unchanged 672 132 0 Form 0920-24ID Recruitment Screener
Form 0920-24ID Consent Form
Form 0920-24ID Focus Group Guide
Form 0920-24ID Interview Recruitment Screener
Form 0920-24ID Travel Med Specialists - Consent Form
Form 0920-24ID Travel Med Specialists - Interview Guide
[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome Unchanged 451 93 0 Form and Instruction 0920-24CA Attachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23
Form and Instruction 0920-24CA Attachment 5 - CDC DVBD - AGS Data Collection - Focus Group Discussion Guide - 12.14.23
Form and Instruction 0920-24CA Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23
Form and Instruction 0920-24CA Attachment 6 - CDC DVBD - AGS Data Collection - Interview Discussion Guide - 12.14.23
[NCZEID] Focus Groups with Consumers on Oropouche Unchanged 264 56 0 Form 0920-25BP Focus Group Screener
Form 0920-25BP Focus Group Discussion Guide
[NCZEID] Formative Communications Assessment on Antimicrobial Resistance Unchanged 1040 201 0 Form 0920-24DM Focus Group Screener
Form 0920-24DM Focus Group Guide for HCPs about Antimicrobial Resistance
Form 0920-24DM Interview Guide for Medical Association about Antimicrobial Resistance
Form 0920-24DM Focus Group Screener for Consumers, Including Parents, and Caregivers
Form 0920-24DM Focus Group Guide for General Consumers about Antimicrobial Resistance
Form 0920-24DM Focus Group Guide for Caregivers about Antimicrobial Resistance
Form 0920-24DM In-Depth Interview Screener for Consumers with Previous Antimicrobial-Resistant Infections
Form 0920-24DM Interview Guide for Consumers with Past Antimicrobial Resistant Infections on Antimicrobial Resistance
Form 0920-24DM Survey on Antimicrobial Resistance Among National Policy Audiences
[NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers Unchanged 1904 302 0 Form 0920-25BU Sandwich Generation Consumer Survey
Form 0920-25BU Sandwich Generation ConsumerScreener
Form 0920-25BU Sandwich Generation Consumer Focus Group Discussion Guide
[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation Unchanged 532 80 0 Form 25-0003 Screener
Form 25-0003 Eligibility Screener
Form 25-0003 Moderator Guide
[NCZEID] Lyme Disease Creative and Message Testing Focus Groups Unchanged 768 154 0 Form 0920-25-0124 Lyme Disease Screener
[NICPC] Child Abuse and Neglect Prevention Message Development Unchanged 189 56 0 Form and Instruction 0920-24BQ Att 1. CAN Survey and Consent
Form and Instruction 0920-24BQ Att 3. CAN Focus Group Eligible Participant Screener 11.21.23
Form and Instruction 0920-24BQ Att 3. CAN Focus Group Eligible Participant Screener rev
[NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees Unchanged 12 6 0 Form and Instruction 0920-1154 Nail Salon Exposure Study Questionnaire (24AA)
Form 0920-1154 (24AA) Nail Salon Exposure Study Questionnaire Feedback Form
[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees Unchanged 12 6 0 Form and Instruction 0920-1154 Nail Salon Exposure Study Questionnaire (24FD)
Form 0920-1154 Nail Salon Exposure Study Questionnaire Feedback Form (24FD)
[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers Unchanged 260 217 0 Form and Instruction n/a Focus Group Conversation Guide for Women Mine Workers
Form and Instruction n/a Focus Group Conversation Guide for Mine Managers and HS Professionals
Form and Instruction n/a Demo
[NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers Unchanged 28 42 0 Form and Instruction 0920-23GU Attmt III- Focus Group Guide - English_Spanish
[NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot Unchanged 75 75 0 Form 0920-25-0059 MVC_Priorities_Interview
Form 0920-25-0059 IVMS_Interview
Form 0920-25-0059 Data_Interview
[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Unchanged 504 539 0 Form and Instruction n/a Focus Group Guide for Employers/Supervisors
Form and Instruction n/a Focus Group Guide for Employees - English/Spanish
Form and Instruction n/a Training for Employers - Pre-test
Form and Instruction n/a Training for Employers - Post-test
Other-Consent
[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research Unchanged 182 68 0 Form and Instruction 0920-1154 Script for Initial Interview with OSH Managers and Trainers
Form and Instruction 0920-1154 Script for Post-Preparation Interview with Osh Managers and Trainers (Prior to Training)
Form and Instruction 0920-1154 Script for POST-TRAINING INTERVIEW with OSH Managers and Trainers
Form and Instruction 0920-1154 Employee Survey
Form 0920-1154 Employee Focus Group Questions
Form 0920-1154 NIOSH Heat Stress Training Log
[NOISH] Customer Discovery Interviews with Five NIOSH Audiences Unchanged 160 160 0 Instruction
[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews Unchanged 100 93 0 Form 0920-25-0094 Request
Form 0920-25-0094 Key Informant
Form 0920-25-0094 Intake Form
[OLSS] CDC OneLab REACH Formative Evaluation Unchanged 50000 12333 0 Form and Instruction n/a Single Sign-Up Survey
Form and Instruction n/a Post Course Evaluation Survey
Form and Instruction n/a User Experience Survey
Form and Instruction n/a Mini Lesson and Job Aid Survey
Form and Instruction n/a Pace and non-Pace Evaluation Survey
[OPHDST] CDC ENGAGE Functionality Project Unchanged 30 30 0 Form 0920-25-0088 Conversation guide
[OPHDST] Foundational User Interviews with the Public Unchanged 120 65 0 Form and Instruction 0920-1154 Foundational Screener (25AB)
Form and Instruction 0920-1154 Foundational Data Collection Interview Scripts (25AB)
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 89074 23699 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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