View Information Collection Request (ICR) Package
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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 Generic ICR - OIRA Conclusion
OMB Control No:
0920-0572
ICR Reference No:
201806-0920-001
Status:
Historical Active
Previous ICR Reference No:
201502-0920-001
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0572
Title:
CDC and ATSDR Health Message Testing System
Type of Information Collection:
Reinstatement without change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
08/13/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/11/2018
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
08/31/2021
36 Months From Approved
Responses
55,575
0
0
Time Burden (Hours)
7,410
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
CDC must communicate about hazards, outbreaks and other emergencies that present an urgent health threat to the public. Untested messages can waste communication resources and opportunities because the messages can be perceived as unclear or irrelevant. OADC-CDC requests a reinstatement without change for the generic clearance for an expedited review of items to be used in health message testing to ensure the public will understand health messages and take recommended action.
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:
83 FR 21776
05/10/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 32124
07/11/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
35
IC Title
Form No.
Form Name
A Tailored Communications Campaign Segment to Prevent Pregnancy-Related Deaths Among American Indian/Alaska Native Women
0920-0572, 0920-0572
Focus Group Recruitment Script and Screener
,
Focus Group Discussion Guide
A Tailored Communications Campaign to Reduce Pregnancy-related Complications and Death
n/a, n/a
Recruitment Script and Screener
,
Focus Group Moderator's Guide
Assessment for the Be Antibiotics Aware (BAA) Consumer Campaign
0920-0572, 0920-0572
BAACS Survey FINAL PRETEST
,
BAA Consumer Survey_FINAL POSTTEST
Assessment for the Be Antibiotics Aware Campaign - Health Care Providers
none, none
BAA Pretest - Heath care providers
,
BAA Posttest - Health care providers
Assessment for the Get Ahead of Sepsis Consumer Campaign
0920-0572, 0920-0572
GAOS Consumer Survey Pre-test HMTS
,
GAOS Consumer Survey Post-test HMTS
Assessment of Get Ahead of Sepsis Camplaign - Health Care Providers
none, none
GAOS Pretest - Health care providers
,
GAOS - Posttest - Health care providers
Be Antibiotic Aware Campaign
none, none, none, none, none
Screener for adults
,
Screener for Nursing Home Caregivers
,
Screener for SS women - English
,
Screener for SS Women - Spanish
,
Screener for Urgent Care adults
Brand Concept Testing for Diabetes Self-Management Education and Support (DSMES) Services Marketing Support
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
PWD Screener for Focus Groups
,
PWD Focus Group Moderators Guide
,
PWD Screener Online Survey
,
PWD Online Survey
,
HCP Screener In Depth Interview
,
HCP In Depth Interview Guide
,
HCP Screener Online Survey
,
HCP Online Survey
CDC Enhanced Message Development and Testing to Prevent Excessive Alcohol Consumption Study – Creative Concept Testing Focus Groups/Copy Testing Survey
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
CDC Alcohol - Creative Concept Testing Rating Worksheet
,
CDC Alcohol Creative Concept Testing Ranking Worksheet - Concerned
,
Creative Concept Testing Ranking Worksheet Uncon&Noncom
,
Creative Concept Testing Rating - concerned
,
Screener
CDC Latent Tuberculosis Infection Campaign: Message Testing with Consumers Born in The Philippines and Vietnam
n/a, n/a, n/a, n/a
Recruitment Screener (English)
,
Recruitment Screener (Vietnamese)
,
Virtual Focus Group Guide for Consumers (English)
,
Virtual Focus Group Guide for Consumers (Vietnamese)
CDC Latent Tuberculosis Infection Campaign: Message and Material Testing with Health Care Providers Who Serve Consumers Born in The Philippines and Vietnam
n/a, n/a, n/a, n/a
Recruitment Screener for Nurse Practitioners and Physician Assistants
,
Recruitment Screener for Physicians
,
Guide for Virtual Interview with Nurse Practitioners or Physician Assistants
,
Guide for Virtual Interview with Physicians
CDC Older Adult Injury Prevention Creative Campaign Survey
0920-0572
Older Adult Injury Prevention Creative Campaign Survey
Communication Emphasizing Consequences, Protective Actions and Target Populations in an Infectious Disease Outbreak
none
Message Testing Instrument
Communication Support for the National Center for Emerging and Zoonotic Infectious Diseases; Anthrax Materials Testing
0920-20MU, 0920-20MU, 0920-20MU, 0920-20MU, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
Screening/Eligibility Form
,
Guide for Adults 65+
,
Guide for Parents
,
Guide for ESL Adults
,
Anthrax Antibiotics & Children Fact Sheet
,
Anthrax Get Vaccinated Fact Sheet
,
Anthrax Pregnancy Fact Sheet
,
Anthrax General Fact Sheet
,
Anthrax POD Fact Sheet
Crisis Next Door Campaign Assessment
0920-0572, 0920-0572
Crisis Next Door Screener
,
Crisis Next Door Questionnaire
Developing Effective Messages about Excessive Alcohol Consumption: Enhanced Message Development and Testing
0920-0572, 0920-0572, 0920-0572
Focus Group Screener
,
Focus Group Discussion Guide
,
Audience Segmentation Survey
Developing Effective Messages about Excessive Alcohol Consumption: Enhanced Message Development and Testing - Revised Screener
0920-0572
Focus Group Screener - Revised
Evaluation of Emergency Use Fact Sheets Regarding Medical Countermeasures – Comprehension
0920-0572, 0920-0572, 0920-0572, 0920-0572
HMTS Evaluation Screener
,
HMTS Evaluation Consent Form
,
HMTS Worksheet Activity
,
HMTS Evaluation IDI Guide
Get Ahead of Sepsis for Healthcare Providers
none, none, none
Screener - EMS Personnel
,
Screener - LTC Med tech/sitter
,
Screener - LTC Nurses
Health Communications Testing for Latent Tuberculosis Infections Campaign
0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT, 0920-20PT
Recruitment Screener_Consumer
,
Recruitment Screener_Nurse-NP-PA
,
Recruitment Screener_Physician
,
Moderator Guide-IDI_Physician
,
Moderator Guide-FG_Nurse-NP-PA
,
Moderator Guide-FG_Consumer
,
Consent Form_Consumer
,
Consent Form_Nurse-NP-PA
,
Consent Form_Physician
Informing Development of CDC Content about Sexually Transmitted Diseases: Focus Groups with Men Who Have Sex With Men
n/a, n/a
Recruitment Guide for MSM
,
Moderator Guides for Web/Telephone Focus Groups
Informing Development of CDC Content about Sexually Transmitted Diseases: Interviews with Healthcare Providers
n/a, n/a
Recruitment Guide for Healthcare Professionals
,
Moderator Guides for Interviews with Healthcare Professionals
Message Testing for Diabetes Self-Management Education and Support (DSMES) Branding: Cart Sort Activity
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
Screener Diabetes Educators
,
Screener Health Care Providers
,
Screener People with DM
,
Diabetes Educators Survey
,
Health Care Providers Survey
,
Person with DM had DSMES Survey
,
Person with DM not had DSMES Survey
Message Testing for Food Safety Content
0920-21DU, 0920-21DU
Digital Screening Form
,
In-depth Interview
Message Testing to Improve Patient-Provider Communication on the Risks of Alcohol Use during Pregnancy
0920-21FM, 092-21FM, 0920-21FM, 0920-21FM, 0920-21FM, 0920-21FM, 0920-21FM, 0920-21FM
Attachment B-HCP QualBoard Screener-MD-NP-PA-MW
,
Attachment L-HCP QualBoard Discussion Guide
,
Attachment E-HCP IDI Screener-RN-MA
,
Attachment E-HCP IDI Discussion Guide -RN-MA
,
Attachment F-WRA QualBoard Screener
,
Attachment F-WRA QualBoard Discussion Board
,
Attachment G-WRA Focus Group Screener
,
Attachment O-WRA Focus Group Discussion Guide
Message Testing: Radiation Emergencies and Cancer Risk
0920-0572
Message Testing Survey
Message and Material Testing for the Get Ahead of Sepsis (GAOS) Campaign for Consumer Audiences
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
Cancer Patients and Caregivers Mod Guide
,
Men Aged 65 and Older Mod Guide
,
Sepsis Survivors and Caregivers Mod Guide
,
Women Who Care for Aging Parent Mod Guide
,
Women Who Care for Child Mod Guide
,
Women Who Primarily Speak Spanish Mod Guide En
,
Cancer Patients Screener
,
Caregivers to Cancer Screener
,
Caregivers to Sepsis Survivors Screener
,
Men Aged 65 and Older Screener
,
Sepsis Survivors Screener
,
Women who Care for Aging Parent Screener
,
Women Who Care for Child Screener
,
Women Who Speak Spanish Screener (Eng)
Message and material testing for the Be Antibiotics Aware (BAA) campaign for healthcare providers (HCPs)
n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a
Screening Form for Dentists
,
Screening Form for Hospitalists
,
Screening Form for Nurses in Nursing Homes
,
Screening Form for Community Pharmacists
,
Screening Form for Advanced Practice Providers and Physicians in Nursing Homes
,
Interviewer Guide for Dentists
,
Interviewer Guide for Hospitalists
,
Interviewer Guide for Nurses in Nursing Homes
,
Interviewer Guide for Community Pharmacists
,
Interviewer Guide for Advanced Practice Providers and Physicians in Nursing Homes
NIOSH Manual of Analytical Methods Survey
n/a
NMAM Customer Satisfaction Survey
National Firefighter Registry
Parents' Knowledge, Skills, Attitudes & Beliefs regarding Children's Bullying: A Research to Practice Approach
0920-0572, 0920-0572, 0920-0572
Focus Group Screener
,
Focus Group Guide English
,
Focus Group Guide Spanish
Sexual Health Study for Gay and Bisexual Men
0920-0572, 0920-0572
Screener - Understanding Sexual Health Messaging among Men who have Sex with Men
,
Focus Group Moderator Guide - Sexual Health Study for Gay and Bisexual Men
Testing Handwashing and Hand Sanitizer Practices Among Spanish-speaking Adults
0920-0572, 0920-0572, 0920-0572
Screener
,
Handwashing Interview Guide
,
Hand Sanitizer Interiview Guide
Testing Health Communication Messages to Promote Hand Hygiene Behavior Among U.S. Adults
0920-0572, 0920-0572
Interview Guide
,
Screening Form
Testing Health Communication Messages to Promote Hepatitis C Testing among U.S. Adults
n/a, n/a
Screener and Focus Group Invitation
,
Focus Group Moderators Guide
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
0
0
0
0
55,575
Annual Time Burden (Hours)
7,410
0
0
0
0
7,410
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
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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:
07/11/2018