View Information Collection Request (ICR) Package
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Common Form Info.
Certification
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:
0920-1027
ICR Reference No:
201407-0920-003
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
14AMW
Title:
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)
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 without change
Conclusion Date:
08/05/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/14/2014
Terms of Clearance:
OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2017
36 Months From Approved
Responses
56,850
0
0
Time Burden (Hours)
37,200
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.
Authorizing Statute(s):
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
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:
79 FR 24432
04/30/2014
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 39402
07/10/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
17
IC Title
Form No.
Form Name
Post-Launch Usability Testing for the CDC HIV Website Redesign (On-line)
Baseline Usability Testing for DHAP's Act Against AIDS Website- Online Survey
NA, NA
Act Against AIDS In-Person Survey
,
Act Against AIDS Online Survey (Screenshots)
CDC Division of STD Prevention Twitter Evaluation
None
Division of STD Prevention Twitter Survey
Customer Satisfaction Assessment of CDC TB Lab Site Visits
none, none
TB Lab Site Visit Assessment
,
TB Labs Site Visit Assessment
Focus Groups for Exploratory Research and Message Pre-Testing Among Foreign-Born Asian Americans
N one
Focus Groups for Exploratory Research and Message Pre-Testing Among Foreign-Born Asian Americans
MSM AYA Stakeholder Analysis Survey
NA, NA
Stakeholder Analysis Adolescent Online Survey
,
Stakeholder Analysis MSM Online Survey
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study
NA
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study
Provider Feedback for Chlamydia Prevention and Control Online Resources
none, none
Recruitment screener
,
Moderator's guide
Research and Message Pre-testing among Baby Boomers - Hepatitis C
none
Screener
Study to Inform HIV Screening and PrEP Resources for Health Care Providers
none, none
Sscreener
,
Consent and Interview Guide
TB DST Reference Center for MTBC Assessment – Online Survey
NA
National PHL DST Reference Center for MTBC Survey
TB Laboratory Site Visit Evaluation Six-Month Follow-Up-Online Survey
N/A, N/A
Appendix 1_Survey Questions_Site Visit Evaluation_ Six month Follow-up
,
Appendix 2_Web Shots_Survey Questions_Site Visit Evaluation_Six Month Follow-up
Take Charge of Your Sexual Health: What you need to know about preventive services: Pre-Testing Hispanic Community
Telephone Interviews to Screen Potential Focus Group Participants for Exploratory Research and Message Pre-Testing Among Foreign-Born Asian Americans
US Public Health Service (USPHS) Medical Officer Healthcare Access Survey
NA
US PHS PPAC Survey on Access to Health Care
User Insights for NCHHSTP Atlas Website and Tool Review _Online Survey
User Insights for NCHHSTP Atlas Website and Tool Review- Interviews
NA
Facilitator Script Interview
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
56,850
0
0
56,850
0
0
Annual Time Burden (Hours)
37,200
0
0
37,200
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 ICR.
Annual Cost to Federal Government:
$370,500
Does this IC contain surveys, censuses, or employ statistical methods?
No
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:
Shari Steinberg 404 639-4942 sxw2@cdc.gov
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:
07/14/2014
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