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 ICR - OIRA Conclusion
OMB Control No:
0920-1425
ICR Reference No:
202507-0920-007
Status:
Active
Previous ICR Reference No:
202310-0920-004
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1425-25-0135
Title:
[NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program
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 with change
Conclusion Date:
07/22/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/10/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2026
12/31/2026
12/31/2026
Responses
72
0
72
Time Burden (Hours)
168
0
168
Cost Burden (Dollars)
0
0
0
Abstract:
The goal of this ICR is to collect data to monitor project performance from grantees funded under Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action. Information collected from recipients will be used to monitor and evaluate progress of program goals and objectives, identify technical assistance needs, and be accountable for the funding by responding to requests for information about the cooperative agreement. The population studied will include 100% of EfC-funded recipients. Therefore, a sampling method is not required. Recipients will report performance data to CDC annually using a web-based system (i.e., Partners’ Portal). No research design or human subjects involved. Information will be also collected via virtual interview sessions. Quantitative data will be analyzed using descriptive and summary statistics. Qualitative data will be analyzed through thematic analysis to define priority area topics and emerging themes. This Non-Substantive Change Request is submitted for compliance with recently issued EOs 14168 and 14151. There is no anticipated change to the approved burden.
Authorizing Statute(s):
US Code:
42 USC 301(a) 241a
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:
88 FR 19308
03/31/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 75591
11/03/2023
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Annual Performance Report (APR) Tool
0920-1425, 0920-
Annual Performance Report (APR) Tool
,
Annual Performance Report (APR) Tool - Revised 22JUL2025
Essentials Instrument and Protocol Evaluation and Surveillance Survey
0920, 0920-1425
Essentials Instrument and Protocol Evaluation and Surveillance Survey
,
Essentials Instrument and Protocol Evaluation and Surveillance Survey - Revised 10JUL2025
Instrument and Protocol Implementation Capacity Assessment (ICA)
0920
Instrument and Protocol Surveillance Capacity Assessment (SCA)
Instrument and Protocol Key Informant Interview - Principal Investigators
0920
Instrument and Protocol Key Informant Interview - Principal Investigators
Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer
0920
Instrument and Protocol Key Informant Interview - Principal Investigators
Instrument and Protocol Surveillance Capacity Assessment (SCA)
0920
Instrument and Protocol Key Informant Interview - Principal Investigators
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
72
72
0
0
0
0
Annual Time Burden (Hours)
168
168
0
0
0
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:
$53,895
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?
No
Agency Contact:
Kennya Burroughs 404 639-4766 vhr4@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:
07/10/2025
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