CDC/ATSDR Formative Research and Tool Development

ICR 201610-0920-009

OMB: 0920-1154

Federal Form Document

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Supplementary Document
2016-10-20
Supplementary Document
2016-10-20
Supplementary Document
2016-10-20
Supporting Statement B
2016-10-20
Supporting Statement A
2017-01-19
IC Document Collections
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239014 New
238970 New
238392 New
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ICR Details
0920-1154 201610-0920-009
Historical Active
HHS/CDC 16AVC
CDC/ATSDR Formative Research and Tool Development
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/19/2017
Retrieve Notice of Action (NOA) 10/26/2016
OMB approves this umbrella generic, and has informed CDC/ATSDR that each individual study should be submitted into ROCIS an a genIC that includes full supporting statement Part A and an accompanying Supporting Statement Part B if any statistical methods are employed for sampling or analyses of data. A complete justification for any incentives offered to respondents will also accompany all substudies submitted under this Generic. Outcomes collected under this generic pathway are intended for internal ATSDR use only and will not be generalized beyond the scope of each study or to broader populations.
  Inventory as of this Action Requested Previously Approved
01/31/2020 36 Months From Approved
60,000 0 0
56,250 0 0
1,125,000 0 0

CDC proposes a new generic clearance to conduct formative research for developing new tools and methodologies to support agency research, surveillance, and program evaluation activities, and the development and assessment of multi-use tools.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  81 FR 46680 07/18/2016
81 FR 73112 10/24/2016
No

35
IC Title Form No. Form Name
BRFSS Preliminary Experiment for Sample and Mode
Increase Enrollment in the CDC-Recognized Lifestyle Change Program (LCP) NA, NA, NA, NA Pre-Session Survey ,   Post-Session Survey ,   Enrollment Materials and Referral Tracking Form ,   LCP Staff/Coach Interview Guide
Federal Select Agent Program eFSAP Feedback Survey 0920-1154, 0920-1154 FSAP Survey System Enhancement ,   FSAP User Experience Survey
Formative Research with Clinicians for the Development of Quantitative Metrics to Improve Antibiotic Prescribing Behavior in the Outpatient Setting
Formative Research to Identify Common and Unique Barriers to the Exchange of Hospitalization and ED Data none, none, none Survey ,   Survey - word ,   Survey prenotice
Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers
Formative Research for Sepsis and Antibiotic Use Campaigns none, none, none, none, none, none, none, none, none, none, none, none, none, none, none Sepsis Consumer Screener - mothers ,   Sepsis Consumer Screener - healthy adults 65+ ,   Sepsis Consumer Screener - AA men ,   HCP Sepsis Screener - ED triage nurse ,   HCP Sepsis Screener - NP or PA ,   HCP Sepsis Screener - PCP ,   HCP Sepsis Screener - Gen med ward ,   Consumer Interview Sepsis ,   HCP Interview Sepsis ,   HCP Antibiotic Use Screener ,   Consumer Screener - SD-SE ,   Consumer Screener - CD - CE ,   HCP Antibiotic Use Interview ,   Consumer Interview - SE - SD ,   Consumer Interview - CE - CD
Formative Evaluation for Shigellosis Sexual Health Materials for Men who have Sex with Men none Screener
Disability and Health Data System Evaluaton Survey 0920-1154 Disability and Halth Data System Evaulation Survey
Formative Assessment of Barriers to Transition from Adolescent to Adult for Individuals with Congenital Heart Defects none Survey of Parents of Adolescents with Congenital Heart Defects
Participatory Mapping to Identy and Support at Risk Population in Emergency Preparedness -- Phase 2
Formative Research to Develop an Open Data Standard for Reporting Environmental Health Data 0920-1154 Key Informant Interview Plan
Reframing How We Talk About Alcohol none Screener
FORMATIVE RESEARCH TO DEVELOP ZIKA TOOLS FOR HEALTHCARE PROVIDERS 0920-1154, 0920-1154, 0920-1154 ACOG Zika Virus Survey ,   Focus Group Recruitment Screen ,   ACOG Evaluation of Local Health Department Initiative
Zika Family Survey: In-Depth Interviews with Women Affected by Zika Virus 0920-1154 IN-DEPTH INTERVIEWS WITH WOMEN AFFECTED BY THE ZIKA VIRUS - INTERVIEW GUIDE
Participatory Mapping to Identify and Support At-Risk Populations in Emergency Preparedness – Phase 3 0920-1154 Survey Disaster Planners
Formative Assessment of the Information Needs to Prevent Work-related Musculoskeletal Disorders and Falls among Aging Retail Workers
Formative Research to Inform an Intervention to Improve Early Detection and Surveillance of Pneumoconiosis in US Coal Miners none, none, none Interview demographic survey ,   Focus group demographic survey ,   Interview sign-up
Participatory Mapping to Identify and Support at-Risk Populations in Emergency Preparedness
Persuasive Communication about Risks from and Responses to Zika: FOCUS GROUPS NA Focus Group - Vignette
CDC's Inside Knowledge Campaign: 2018 Focus Group Research and Testing with the General Public and Hispanic Audiences n/a, n/a, n/a, n/a English Language Screening Instrument ,   Spanish Language Screening Instrument ,   English Language Focus Group Discussion Guide ,   Spanish Language Focus Group Discussion Guide
Behavioral Determinants of Community Hand Hygiene Behavior: A Formative Qualitative Evaluation 0920-1154, 0920-1154 Online Screener ,   Focus Group Moderator Guide
Ethnicity & Race: Messaging to Improve Patient-Provider Communication and Engagement on Risks of Alcohol Use During Pregnancy 0920-1154, 0920-1154, 0920-1154, 0920-1154 Consent Form Provider (Online Survey) ,   Consent Form Provider In-Depth Interview ,   Consent Form Women In-Depth Interview ,   Provider Screener and Online Survey
Reaching Minority Men Where They Are – Formative Research to Build Capacity for Enrollment in Diabetes Prevention and Management Programs n/a, n/a, n/a, n/a, n/a Focus Group Guide: Minority Men at Risk for Type 2 Diabetes ,   Focus Group Guide: Minority Men Diagnosed with Type 2 Diabetes ,   Screener ,   Initial Screen Shot of the Web-based Survey (with OMB control information) ,   Survey (content)
Assessment of the Zika Care Connect Program 0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154 Invitation Email to access Survey - Health Care Professional ,   Reminder Invitation Email to access Survey - Health Care Professional ,   Survey - Healthcare Professional ,   Pop-Up Invitation to Survey - Website User ,   Survey - Website User
Older Adult Mobility Ride Share (OAMRS) 0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154 Written Questionnaire Focus Group ,   Focus Group Protocol - Users ,   Focus Group Protocol - Non-Users ,   Interview Protocol - Users ,   Interview Protocol - Non-Users ,   Screener Focus Group ,   Screener Telephone Interview
Clinician Preferences for CDC Clinical Guidelines
Formative Research to Assess Pediatric Healthcare Providers Knowledge, Attitudes and Practices around Zika Virus none Survey of Experiences with and Attitudes towards Zika Virus
Core Elements of Antimicrobial Stewardship in Nursing Homes none Prescriber Assessment
BRFSS Feasibility Experiment for State-specific Module Data Collection in Cell Phone Samples 0920-1154 Questionnaire Content
Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention none, none Recruitment Screener ,   Recruitment Follow-up Contact
2019 Updated B Reader Certification Examination
Determination of Attitudes Regarding Noise in Construction 0920-1154, 0920-1154, 0920-1154, 0920-1154 Construction Industry Executive/Decision-Maker In-Depth Interviews ,   Construction Supervisor/Foreman Focus Group ,   Construction Workers Focus Groups (ENGLISH) ,   Construction Workers Focus Groups (SPANISH)
Persuasive Communication about Risks from and Responses to Zika – State, Local and Tribal Government Interviews NA Interview Guide - Public Health Officials
Antibiotic Stewardship in Hospitals Assessment none, none Hospital Antibiotic Stewardship Core Element Assessment ,   Feedback Questionnaire

  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 60,000 0 0 60,000 0 0
Annual Time Burden (Hours) 56,250 0 0 56,250 0 0
Annual Cost Burden (Dollars) 1,125,000 0 0 1,125,000 0 0
Yes
Miscellaneous Actions
No
This is a new generic ICR.

$474,091
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 sxw2@cdc.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/26/2016


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