Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

ICR 202102-0920-003

OMB: 0920-1129

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form
Removed
Form
Removed
Form
Removed
Form and Instruction
Removed
Form and Instruction
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form and Instruction
Removed
Form and Instruction
Removed
Form and Instruction
Removed
Form and Instruction
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form and Instruction
Removed
Form and Instruction
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form
Removed
Form and Instruction
Removed
Supplementary Document
2021-02-05
Supplementary Document
2021-02-05
Supplementary Document
2021-02-05
Supplementary Document
2021-02-03
Supplementary Document
2021-02-03
Supplementary Document
2021-02-03
Supplementary Document
2021-02-03
Supporting Statement B
2021-02-03
Supporting Statement A
2021-02-03
IC Document Collections
IC ID
Document
Title
Status
245669 New
245668 New
245667
New
245666 New
245665
New
245664 New
245663 New
245662 New
245661
New
245659 New
245656 New
245653
New
245652 New
245650 New
245648 New
245559 New
245558 New
220433 Removed
220432 Removed
220431 Removed
220430 Removed
220429 Removed
220428 Removed
220427 Removed
220426 Removed
220425 Removed
220423 Removed
220422 Removed
220421 Removed
220419 Removed
220418 Removed
220417 Removed
220416 Removed
220414 Removed
220412 Removed
220411 Removed
220410 Removed
220408 Removed
220407 Removed
220405 Removed
220404 Removed
220403 Removed
220402 Removed
220401 Removed
220400 Removed
220399 Removed
220398 Removed
220397 Removed
220396 Removed
220395 Removed
220394 Removed
220392 Removed
220391 Removed
220390 Removed
220389 Removed
220388 Removed
220387 Removed
220386 Removed
220385 Removed
220384 Removed
220383 Removed
220382 Removed
220381 Removed
220379 Removed
220378 Removed
220377 Removed
220375 Removed
ICR Details
0920-1129 202102-0920-003
Received in OIRA 201707-0920-006
HHS/CDC 0920-1129
Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships
Reinstatement without change of a previously approved collection   No
Regular 02/08/2021
  Requested Previously Approved
36 Months From Approved
16,938 0
2,332 0
0 0

The purpose of this information collection is to assess and address the knowledge, attitude, skills and practice behaviors of healthcare professionals to prevent, identify, and treat fetal alcohol spectrum disorders (FASDs). Data collected will be used to inform the development of, and determine the effectiveness of, trainings and other resources for the prevention, identification, and treatment of FASDs. Needs assessment and training data will be collected either electronically, via paper/pencil, or web-based survey. Qualitative data collections will be conducted by phone or in-person.

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

Not associated with rulemaking

  85 FR 64469 10/13/2020
86 FR 7396 01/28/2021
No

17
IC Title Form No. Form Name
Medical Assistants Post-Test Survey 0920-1129 B7 Medical Assistants Post-Test Survey
Post-Test Screening, Assessment, and Diagnosis 0920-1129 B10 Post-Test Screening, Assessment and Diagnosis
Pre-Training Survey (Nursing) none Nursing Pre-Training Survey
Six-Month Follow-Up Training Survey (Nursing) none Nursing Training Follow-up Survey
Organizational Readiness Survey none Organizational Readiness Survey
Pre-Training Survey (Nursing) none Nursing Post-training Survey
FASD Prevention, Identification, & Alcohol Screening Post-Training Evaluation (previously NO FAS Post-Test Survey) 0920-1129 FASD Prevention, Identification, & Alcohol Screening Post-Training Evaluation
Clinical Process Improvement Survey none Clinical Process Improvement Survey
High Impact Study - Informant Interview
Nursing DSW Polling none Nursing DSW Polling
TCU Organizational Readiness Survey none TCU Organizational Readiness Survey
FASD Prevention, Identification, & Alcohol Screening Pre-Training Evaluation (previously NOFAS Pre-Test Survey) 0920-1129 FASD Prevention, Identification, & Alcohol Screening Pre-Training Evaluation
NOFAS Webinar 3 month Survey none NOFAS Webinar 3 month Survey
OBGYN Provider Follow-up none OBGYN Provider Follow-up
Social Work and Family Physician Follow-up Survey none Social Work and Family Physician Follow-up Survey
OBGYN FASD-SBI Training Event Evaluation 0920-1129 OBGYN FASD-SBI Training Event Evaluation
OBGYN Informant Interview - Pretraining none OBGYN Informant Interview - Pretraining
OBGYN Knowledge and Agency none OBGYN Knowledge and Agency
Nursing Organization Questionnaire nopne Nursing Organization Questionnaire
Nursing Informant Interview
NOFAS Webinar Survey none NOFAS Webinar Survey
Medical Assistants Change in Practice Survey none Medical Assistants Change in Practice Survey
AAP 6 Month Follow-up Evaluation Survey (Pediatrics) 0920-1129 AAP Six-Month Follow-Up Evaluation Survey
Nursing Network Survey none Nursing Network Survey
Healthcare Organization Survey none Healthcare Organization Survey
OBGYN Provider Skills Baseline none OBGYN Provider Skills Baseline
Social Work and Family Physician Post-training Survey none Social Work and Family Physician Post-training Survey
OBGYN Guided Brief Intervention Satisfactory Survey (previously OBGYN Avatar Training Satisfaction Survey) 0920-1129 OBGYN Guided Brief Intervention Satisfaction Survey
Social Work and Family Physician Pre-training Survey none Social Work and Family Physician Pre-training Survey
Pediatricians Survey none Survey of Pediatricians
AAP 3 Month Follow-up Survey (Pediatrics) 0920-1129 AAP Three-month Follow-up Evaluation Survey
AAP Pre-Training Evaluation Survey (Pediatrics) 0920-1129 Academia Americana De Pediatria Encuesta De Evaluacion De Seguimento De 6 Meses
FASD Core Training - 6 month follow-up none FASD Training Survey - follow-up
DSW Report none DSW Report
OBGYN Standardized Patient none OBGYN Standardized Patient
OBGYN Informant Interview - Posttraining none OBGYN Informant Interview - Posttraining
OBGYN Telecom Training Survey 0920-1129 OBGYN Telecom Training Satisfaction Survey (TTS)
Medical Assistants Pre-test Survey none Medical Assistants Pre-test Survey
Medical Assistants Pre-test Survey - Academic none Medical Assistants Pre-test Survey - Academic
Medical Assistants Follow-up Survey - Academic none Medical Assistants Folow-up Survey - Academic
Family Medicine Evaluation none Family Medicine Evaluation
AAP Post-Training Evaluation Survey (Pediatrics) 0920-1129 Academia Americana De Pediatria Ciiestionario De Elaluacion Posterior A La Capacitacion
FASD Training Evaluation none FASD Training Evaluation
Medical Assistants Post-test Survey - Academic none Medical Assistants Post-test Survey - Academic
FASD Toolkit User Survey none FASD Toolkit User Survey
Key Informant Interviews with Champions 0920-1129 B5 Key Informant Interviews with Champions
Medical Assistants Pre-Test Survey
HIgh Impact Study - Discussion Guide
FASD Core Training Survey Post-Test 0920-1129 Core Post-Training Survey
Health Professionals Survey (Nursing) 092-1129 Health Professionals Survey_Nursing
Medical Assistants Change in Practice Survey 0920-1129 B8 Medical Assistants Change in Practice Survey
FASD Toolkit Focus Group Guide
FASD Work Plan none FASD Work Plan
Health Professionals Survey 0920-1129 Health Professionals Survey
Core Pre Test 0920-1129 Core Pre-Test Survey
FASD Core Training Survey - Post-test none FASD Post-training survey
Medical Assistants Post-test Survey none Medical Assistants Post-test Survey
Medical Assistants Follow-up Survey none Medical Assistants Follow-up Survey
FASD Core Training Survey Pre-test 0920-1129 FASD Prevention, Identification & Alcohol Screening Pre-Training Evaluation
Pre-Test Screening, Assessment, and Diagnosis
Pre-Test ND-PAE 0920-1129 B11 Pre-test ND-PAE
Post-Test ND-PAE 0920-1129 B12 Post-test ND-PAE
Pre-Test Treatment Across the Lifespan
Post-Test Treatment Across the Lifespan 0292-1129 B14 Post-Test Treatment Across Lifespan
Social Work and Family Physicians Pre-Training Survey
Social Work and Family Physicians 6 Month Follow-Up 0920-1129 B16 Social Work & Family Physicians Pre-Training SurveyWeb-based version
TCU Organizational Readiness Survey 0920-1129 B17 TCU Organizational Readiness Survey

  Total Request 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 16,938 0 0 16,938 -31,577 31,577
Annual Time Burden (Hours) 2,332 0 0 2,332 -3,748 3,748
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
CDC is requesting approval for 2,338 burden hours. This reinstatement is requesting a decreased burden time (previously 3709 hrs.). This change largely occurs due to the reduction in the number of instruments being used. The total number of data collection instruments has decreased by 33 instruments. This notice has a 30-day comment period; CDC is requesting a three-year approval.

$830,120
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 lta2@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.
02/08/2021


© 2024 OMB.report | Privacy Policy