The Centers for Disease Control and Prevention (CDC) Study on Disparities in Distress Screening among Lung and Ovarian Cancer Survivors

ICR 201906-0920-006

OMB: 0920-1270

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Supplementary Document
2019-06-20
Supporting Statement A
2019-06-20
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supplementary Document
2019-06-17
Supporting Statement B
2019-06-17
ICR Details
0920-1270 201906-0920-006
Historical Active
HHS/CDC 0920-19MM
The Centers for Disease Control and Prevention (CDC) Study on Disparities in Distress Screening among Lung and Ovarian Cancer Survivors
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/09/2019
Retrieve Notice of Action (NOA) 07/05/2019
  Inventory as of this Action Requested Previously Approved
10/31/2020 12 Months From Approved
184 0 0
512 0 0
0 0 0

The purpose of this study is to examine the extent to which disparities exist in distress screening and follow-up care among cancer treatment facilities and programs across the country. CDC believes that it is imperative to develop a greater understanding about the types of services for lung and ovarian cancer survivors because they experience high levels of distress and are among those who experience the lowest 5-year survival rates.

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

Not associated with rulemaking

  84 FR 8100 03/06/2019
84 FR 32179 07/05/2019
No

4
IC Title Form No. Form Name
Focus Groups 0920-19MM Focus Group Interview Guide
Healthcare Professionals Survey
EHR Data 0920-19MM EHR data collection tool
Key Informant Interview Guide and Consent 0920-19MM Key Informant interview guide

  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 184 0 0 184 0 0
Annual Time Burden (Hours) 512 0 0 512 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection

$142,077
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Kevin Joyce 404 639-1944 kdj7@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.
07/05/2019


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