View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0920-0932
ICR Reference No:
201203-0920-007
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Data Collection for Evaluation of Education, Communication, and Training Activities
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:
05/07/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/23/2012
Terms of Clearance:
Approved consistent with the following terms of clearance: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2015
36 Months From Approved
Responses
166,500
0
0
Time Burden (Hours)
66,498
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This is generic request for Evaluating Education, Communication, and Training Activities within the National Center for Emerging and Zoonotic Infectious Disease's Division of Global Migration and Quarantine Division (DGMQ).
Authorizing Statute(s):
US Code:
42 USC 361
Name of Law: Public Health Service
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:
76 FR 49487
08/10/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 76415
12/07/2011
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
Evaluating the Effectiveness of Ebola CARE Plus Program
None, None, None, None, None
In-person survey of traveler intercepted at the airport
,
Telephone survey within 3-5 days after airport survey
,
Telephone Survey 2 Days before Last Scheduled Day To Report to Health Department
,
Data Request to Health Departments
,
Cultural Sensitivity Assessment Tool
Evaluating the Effectiveness of Ebola CARE Program
0920-0932, 0920-0932, 0920-0932
Attachment A_Final CARE Program_ECT_Intercept Interview Guide_12 10 14
,
Attachment C_Final CARE Program_ECT_Telephone Interview Guide_12 10 2014
,
Attachment F_Ebola CARE Kit_12 5 14
Evaluating the Effectiveness of Quick Response Codes in Educating Panel Physicians
None, None
Statement of Consent for Pre-Knowledge Aptitude Survey
,
Statement of Consent for Semi-Structured Aptitude Questionnaire
Evaluation of Adapted Health Education Materials for LEP Spanish-Speakers and Indigenous Migrants
none
Screener
Evaluation of the TravAlert Electronic Messaging System
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
166,500
0
0
166,500
0
0
Annual Time Burden (Hours)
66,498
0
0
66,498
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 request is for a new Generic Clearance.
Annual Cost to Federal Government:
$4,670,000
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?
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?
Uncollected
Agency Contact:
Petunia Gissendaner 4046390164
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:
03/23/2012
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