View Information Collection Request (ICR) Package
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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:
0920-0572
ICR Reference No:
201501-0920-003
Status:
Historical Active
Previous ICR Reference No:
201111-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
15JW
Title:
CDC and ATSDR Health Message Testing System
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/06/2015
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/06/2015
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
02/28/2015
02/28/2015
02/28/2015
Responses
55,575
0
55,575
Time Burden (Hours)
7,510
0
7,410
Cost Burden (Dollars)
0
0
0
Abstract:
CDC would like to process a GenIC for information collection scheduled to ocurr in January-February w015 (i.e., before the Extension ICR can be processed). The number of responses available in the current HMTS inventory is sufficient ot process the GenIC, however, the number of burden hours is insufficient. CDC requests a minor adjustment (Increase) in the number of burden hours currently allocated to the HMTS.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service 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:
76 FR 68358
07/26/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 189
09/29/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
20
IC Title
Form No.
Form Name
Act Against AIDS Campaign
none, none, none, none, none, none
Screener - MSM
,
Interview - MSM
,
Screener - HIV+
,
Interview - HIV+
,
Interview - General Population
,
Invitation - General Population
African American STD Disparities Health Communications Project and Community Health Media Center Educational Campaign Materials Testing
none, none, none, none, none, none, none, none, none, none
African American Screener
,
African American Survey
,
Community Health Wave 1 Screener
,
Community Health Wave 2 Screener
,
Community Health Wave 3 Screener
,
Community Health Wave 4 Screener
,
Community Health Wave 1 Survey Screenshots
,
Community Health Wave 2 Survey Screenshots
,
Community Health Wave 3 Survey Screenshots
,
Community Health Wave 4 Survey Screenshots
Agency for Toxic Substances and Disease Registry Task Order 15: Message Testing
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
ATSDR-Message-Testing_Attachment-2_Screener-Consumers_Clean
,
ATSDR-Message-Testing_Attachment-5_Consumers
,
ATSDR-Message-Testing_Attachment-6_PublicHealthProfessionals
,
ATSDR-Message-Testing_Attachment-7_Communitymembers
,
ATSDR-Message-Testing_Attachment-8_Consent-Form
Audience Research on Self-Management Education
none, none
Moderator's Guide
,
Screener
Audience Research on Self-Management Education, Phase III
0920-0572, 0920-0572
Attachment 4 Screener_10282014
,
Attachment 3 Mod Guide_10282014
CHMC-Testing Educational Campaign Materials with African American and Hispanic Audiences
Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing
Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)
none, none
Screener in English and Spanish
,
Dicussion Guide in English and Spanish
HMTS Radiation Focus Group and Emergencies Infographics
Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders
0920-0572, 0920-0572, 0920-0572
Moderators Guide- Engaged Public Triad
,
Moderators Guide- Community Leaders Triad
,
Moderators Guide- General Public FG
Msg Testing for (3) Expedited Reviews--Detonation of an Improv Nuc Devise (Span), AND Impact of a Truck Driver Pub Hth Prac Proj, AND Dissemination of Occup Safety & Hlth Materials thru Mex Consul
none, none, none, none
Screening Instrument
,
Truck Driver Opinion Survey
,
Exit Survey_Spanish
,
Exit Survey_English Translation
Pandemic Influenza Nonpharmaceutical Intervention Message Testing
none, none
Screener
,
Moderator's Guide
Parents are the Key Teen Driving Safety Initiative
none, none, none, none, none, none
Pediatrician Screener
,
Parent Message Testing Moderator's Guide
,
Parent Message Testing Moderator's Guide - Spanish
,
Pediatrician Message Testing Moderator's Guide
,
Parent Screener
,
Parent Screener - Spanish
Planes,Trains and Auto-Mobility: Increase Walking in the Atl Hartsfield-Jackson Arprt And Testing of brand concepts, msgs and material CDC National Diabetes Prevntion Program
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
Planes, Trains and Autop Appendix B3 Response Form
,
Planes, Trains and Auto Appendix B Instructions for Interview
,
Plane, Trains and Auto Appendix B 1 Interview 1
,
Planes, Trains and Autop Appendix B2 Interview Cards 1
,
Planes, Trains Auto Appendix B4 Participant Inform
,
Plane, Trains and Auto Appendix 5 Question 1 Rationale
,
Plane, Train Auto Appendix C Handheld Screenshots
,
Testing of brand Appendix A1-Screener-Consumers 010
,
Testing of brand concepts Appendix A2-Screener-HCP
,
Testing of brand concepts Appendix B1-Consent form
,
Testing of brand concepts Appendix B2-Consent form-
,
Testing of Brand Appendix C1-Moderators Guide- Consumers FG
,
Testing of brands Appendix C2-Moderators Guide- HCP triads
,
Testing of brand Appendix D2-NDPP Branding Message Testing Supplement
Radiation Emergencies Infographics Focus Groups
None
Screening Instrument-Radiation Emergencies Infographics
Spanish Trench Safety CD-ROM
none, none
Survey - Spanish
,
Recruitment Script
Storyboard Testing Focus Groups for "No Trespassing Means No Trespassing" Campaign
Testing Business-Case Videos for CDC's Division of Community Health
none, none, none
Interview Guide for Videos
,
Eligibility Screener for Business people
,
Survey for Video Testing
Testing Health Messages in STEADI Oder Adult Fall Pevention Materials Among Caregivers
None
Informed Consent
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
55,575
55,575
0
0
0
0
Annual Time Burden (Hours)
7,510
7,410
0
0
100
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$1,550,000
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:
Thelma Sims 4046394771
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:
01/06/2015
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