School Health Policies and Practices Study 2012

Forms and Documents

Document Name	Status
Form 24 Classroom Data Collection Form and Instruction	Removed
SS Part B - SHPPS 2014 and 2016 28 Mar 2013.docx Supporting Statement B	2013-06-24
Appendix K Proposed Changes.docx Supplementary Document	2013-06-26
Appendix D-2 - National Reviewers Directory.docx Supplementary Document	2013-06-25
Appendix D-1 - Content Panel Participant.docx Supplementary Document	2013-06-25
Appendix B 60 Day FRN.pdf Supplementary Document	2013-06-24
Appendix A - Authorizing Legislation.docx Supplementary Document	2013-06-24
Appendix H-6 - School Letter of Invitation for SHPPS 2014.doc Supplementary Document	2013-06-24
Appendix J-2- Study Fact Sheet for SHPPS 2016.docx Supplementary Document	2013-06-25
Appendix I-3 State Letter of Invitation for SHPPS 2016.doc Supplementary Document	2013-06-24
Appendix J-1 - Study Fact Sheet for SHPPS 2014.docx Supplementary Document	2013-06-25
Appendix H-4 State Letter of Invitation for SHPPS 2014.doc Supplementary Document	2013-06-24
Appendix G-17 Screen Shots - Web-based District Survey.docx Supplementary Document	2013-06-25
Appendix I-4 District Letter of Invitation for SHPPS 2016.doc Supplementary Document	2013-06-25
Appendix J-2- Study Fact Sheet for SHPPS 2016.docx Supplementary Document	2013-06-25
Appendix I-2 District Recruitment Script 2016.docx Supplementary Document	2013-06-25
Appendix G-17 Screen Shots - Web-based District Survey.docx Supplementary Document	2013-06-25
Appendix J-1 - Study Fact Sheet for SHPPS 2014.docx Supplementary Document	2013-06-25
Appendix H-5 District Letter of Invitation for SHPPS 2014.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-3 District Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix I-5 District Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-2 Classroom Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-2 Classroom Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix H-5 District Letter of Invitation for SHPPS 2014.doc Supplementary Document	2013-06-24
Appendix I-4 District Letter of Invitation for SHPPS 2016.doc Supplementary Document	2013-06-24
Appendix H-5 District Letter of Invitation for SHPPS 2014.doc Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
Appendix H-7 School- and Classroom-level Content Outlines.doc Supplementary Document	2013-06-24
Appendix E-1 School Participant Notification Document.docx Supplementary Document	2013-06-24
SS Part A - SHPPS 2014 and 2016.docx Supporting Statement A	2013-06-24

IC Document Collections

IC ID	Document Title	Status
6869	School Health Education Other-WORD	Modified
207691	School Recruitment Script Other-WORD	New
207690	State Recruitment Script (2016) Other-WORD	New
207689	State Recruitment Script (2014) Other-WORD	New
207688	District Recruitment Script (2016) Other-WORD	New
207687	District Recruitment Script (2014) Other-WORD	New
207686	District Faculty and Staff Health Promotion Other-WORD	New
207685	District Mental Health and Social Services Other-WORD	New
207684	District Healthy and Safe School Environment Other-WORD	New
207683	District Nutrition Services Other-WORD	New
207682	District Health Services Other-WORD	New
207681	District Physical Education and Activity Other-WORD	New
207680	School Faculty and Staff Health Promotion Other-WORD	New
207679	School Mental Health and Social Services Other-WORD	New
207678	District Health Education Other-WORD	New
207677	Classroom Physical Education and Activity Other-WORD	New
207676	Classroom Health Education Other-WORD	New
197640	Classroom Data Collection Form and Instruction	Removed
197639	Healthy and Safe School Environment Other-WORD	Modified
197638	School Nutrition Services Other-WORD	Modified
197637	School Health Services Other-WORD	Modified
197636	School Physical Education and Activity Other-WORD	Modified

ICR Details

OMB Control No: 0920-0445	ICR Reference No: 201307-0920-004
Status: Historical Active	Previous ICR Reference No: 201105-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 19752
Title: School Health Policies and Practices Study 2012
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/16/2013
	Date Received in OIRA: 07/09/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved
Responses	13,862	0	0
Time Burden (Hours)	9,722	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests OMB approval to conduct a national study of school health policies and practices at the state, district, school, and classroom levels. Information will be collected in the spring of 2012.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 9919	02/12/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 34385	06/07/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 21

IC Title	Form No.	Form Name
School Mental Health and Social Services
School Faculty and Staff Health Promotion
District Physical Education and Activity
District Health Services
District Nutrition Services
District Healthy and Safe School Environment
District Mental Health and Social Services
District Faculty and Staff Health Promotion
District Recruitment Script (2014)
District Recruitment Script (2016)
State Recruitment Script (2014)
State Recruitment Script (2016)
School Recruitment Script
Classroom Data Collection	24, 25	Health Education Classroom Questionnaire ,   Health Education Classroom Questionnaire
Healthy and Safe School Environment
Classroom Health Education
Classroom Physical Education and Activity
District Health Education
School Health Education
School Physical Education and Activity
School Health Services
School Nutrition Services

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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	13,862	0	0	13,862	0	0
Annual Time Burden (Hours)	9,722	0	0	9,722	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 reinstatement with changes seeks to conduct a SHPPS in 2016 that will collect information only at the district level and will replicate methods and processes previously approved in the 2012 cycle of SHPPS.

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Annual Cost to Federal Government: $7,202,990

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? Yes

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

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Common Form ICR:  No

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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: 07/09/2013

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