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View Information Collection (IC) List
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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:
0920-0876
ICR Reference No:
201010-0920-010
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Case Studies of Selected Communities and States Funded under Community Activities under the Communities Putting Prevention to Work (CPPW) Initiative
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
01/17/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/29/2010
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2013
24 Months From Approved
Responses
528
0
0
Time Burden (Hours)
678
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
CDC proposes to conduct case studies of selected CPPW states and communities to gain insight into the factors that facilitate or hinder the implementation of MAPPS strategies for improving nutrition and physical activity, and decreasing the prevalence of obesity and tobacco use. Information will be collected at personal interviews conducted at each case study site.
Authorizing Statute(s):
PL:
Pub.L. 111 - 5 VIII
Name of Law: American Recovery and Reinvestment Act of 2009
US Code:
42 USC 241
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 148 4002
Name of Law: Patient Protection and Affordable Care 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:
75 FR 11184
03/10/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 65355
10/22/2010
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
CPPW Management Interview
none
Att 8 - Interview Guide for Management Staff
CPPW Staff Interview
none
Att 8 - Interview Guide for Staff
Community Partners Interview, Private Sector
none
Att 9 - Guide for Community Partners
Community Partners Interview, State and Local Government Sector
none
Att 9 - Interview Guide for Community Partners
Interview Planning Tool
none
Interview Planning Tool
Interview Planning Worksheet
none
Att 11 - Worksheet for Scheduling Interviews
Policy and Decision Makers Interview, Private Sector
none
Interview Guide for Policy Makers
Policy and Decision Makers Interview, State and Local Government Sector
none
Att 10 - Interview Guide for Policy Makers
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
528
0
0
528
0
0
Annual Time Burden (Hours)
678
0
0
678
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:
This is a new data collection required as part of a comprehensive evaluation of Communities Putting Prevention to Work, a ARRA funded initiative.
Annual Cost to Federal Government:
$1,571,528
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?
Yes
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:
Carol Walker 4046394773
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:
10/29/2010
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