[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research

[OS] CDC/ATSDR Formative Research and Tool Development

Documents and Forms

Document Name Document Type
Form 0920-1154 [NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research Form and Instruction
0920-1154 Script for Initial Interview with OSH Managers and Train Attachment B1 Initial Interview Script.docx Form and Instruction
0920-1154 Script for Post-Preparation Interview with Osh Managers Attachment B2 PostPrep Interview Script.docx Form and Instruction
0920-1154 Script for POST-TRAINING INTERVIEW with OSH Managers and Attachment B3 PostTraining Interview Script.docx Form and Instruction
0920-1154 Employee Survey Attachment C Employee Survey.docx Form and Instruction
0920-1154 Employee Focus Group Questions Attachment D Employee Focus Group.docx Form
0920-1154 NIOSH Heat Stress Training Log Attachment E Training Log.docx Form
Attachment A Federal Mine Safety and Health Act of 1977.pdf Authorizing Legislation IC Document
Attachment F IRB exemption.pdf IRB Determination IC Document
Attachment G Informed Consent.docx Informed Consent IC Document
SSA.071224 (24HH).docx SSA IC Document
Heat stress training SSB_final_062824.docx SSB IC Document
GenICRequest_HeatStressTraining.docx Request for Approval under the “Formative Research and Tool Development” (OMB Control Number: 0920-1154) IC Document

Information Collection (IC) Details

IC Title:	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Agency IC Tracking Number:	0920-1154-24HH

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	0920-1154	Script for Initial Interview with OSH Managers and Trainers	Attachment B1 Initial Interview Script.docx	No	Paper Only
Form and Instruction	0920-1154	Script for Post-Preparation Interview with Osh Managers and Trainers (Prior to Training)	Attachment B2 PostPrep Interview Script.docx	No	Paper Only
Form and Instruction	0920-1154	Script for POST-TRAINING INTERVIEW with OSH Managers and Trainers	Attachment B3 PostTraining Interview Script.docx	No	Paper Only
Form and Instruction	0920-1154	Employee Survey	Attachment C Employee Survey.docx	No	Paper Only
Form	0920-1154	Employee Focus Group Questions	Attachment D Employee Focus Group.docx	No	Paper Only
Form	0920-1154	NIOSH Heat Stress Training Log	Attachment E Training Log.docx	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 182	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	182	182
Annual IC Time Burden (Hours)	68	68
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Legislation	Attachment A Federal Mine Safety and Health Act of 1977.pdf	07/11/2024
IRB Determination	Attachment F IRB exemption.pdf	07/11/2024
Informed Consent	Attachment G Informed Consent.docx	07/11/2024
SSA	SSA.071224 (24HH).docx	07/15/2024
SSB	Heat stress training SSB_final_062824.docx	07/11/2024
Request for Approval under the “Formative Research and Tool Development” (OMB Control Number: 0920-1154)	GenICRequest_HeatStressTraining.docx	07/15/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.