Evaluation of the Chronic Disease Self-Management Program in the US Affiliated Pacific Islands

ICR 201901-0920-012

OMB: 0920-1265

Federal Form Document

IC Document Collections
ICR Details
0920-1265 201901-0920-012
Active
HHS/CDC 0920-18FJ
Evaluation of the Chronic Disease Self-Management Program in the US Affiliated Pacific Islands
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/05/2019
Retrieve Notice of Action (NOA) 02/15/2019
Approved consistent with the understanding that CDC will not be conducting any general research on the information collected. When communicating findings from this collection, all publications will clearly describe the scope and limitations of the study findings.
  Inventory as of this Action Requested Previously Approved
06/30/2021 24 Months From Approved
570 0 0
95 0 0
570 0 0

This collection is to evaluate the first implementation of Stanford University's Chronic Disease Self-Management Program in the US Affiliated Pacific Islands. The evaluation will assess program participation satisfaction with the program and participants' overall health and health behaviors before and after the program.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  83 FR 4917 02/02/2018
84 FR 4469 02/15/2019
No

2
IC Title Form No. Form Name
Chronic Disease Self-management Workshop Evaluation none Workshop Evaluation
Chronic Disease Self-management Questionnaire none Workshop 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 570 0 0 570 0 0
Annual Time Burden (Hours) 95 0 0 95 0 0
Annual Cost Burden (Dollars) 570 0 0 570 0 0
Yes
Miscellaneous Actions
No
This is a new ICR

$19,501
Yes Part B of Supporting Statement
    No
    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.
02/15/2019


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