A Site-Specific Modular Evaluation Instrument for Behavior Outcome Measurement

ICR 200707-0923-001

OMB:

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Form and Instruction
New
Supporting Statement B
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supplementary Document
2007-06-22
Supporting Statement A
2007-06-22
ICR Details
200707-0923-001
Historical Inactive
HHS/TSDR
A Site-Specific Modular Evaluation Instrument for Behavior Outcome Measurement
New collection (Request for a new OMB Control Number)   No
Regular
Withdrawn 02/27/2008
Retrieve Notice of Action (NOA) 07/13/2007
In accordance with 5 CFR 1320, the information collection is withdrawn at the agency's request.
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0

In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to implement the health-related sections of laws that protect the public from hazarous wastes and environmental spills of hazardous substances. ATSDR is the lead agency with the Public Health Service for implementing the health-related provisions of CERCLA, the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, commonly known as the Superfund Act. Under this Act, ATSDR is charged with assessing the presence and nature of health hazards at Superfund sites to help prevent or reduce further exposure and the illnesses that result from such exposures. ATSDR provides cooperative agreement funding and technical assistance to states and works closely with state agencies to carry out its mission. Evaluation is a critical component in ATSDR's site-related public health actions, both to ensure the successful application of site-specific/site-related intervention activities, and the effective management of resources. However, ATSDR does not currently have an agency-wide standardized measurement instrument to obtain, analyze and strategically examine the outcomes of its health education and health promotion activities. ATSDR requests OMB approval of a set of standardized survey modules that will be used to determine knowledge improvements, attitude shifts, and behavior change following ATSDR's site-specific program efforts and activities. The modules are: (1) knowledge and beliefs; (2) behaviors; (3) stress; (4) health related quality of life; (5) intention to change; and (6) social demographics. The particular module(s) selected for use at a site will vary depending on the contaminant of concern, environmental medic, environmental pathway, and education/health promotion actions taken in response to the site conditions. The modular framework will allow customization of the survey instrument at each site specific to contaminant(s), environmental media, and route(s) of exposure found at the site as well as potentially contributing factors. Contaminants of interest include: metals; volatiles; polycyclic aromatic hydrocarbons (PAHs) and benzo(a)pyrene; asbestos; dioxin; and polycholorinated biphenyls (PCBs) and mercury. ATSDR plans to conduct the majority of surveys through its cooperative agreement partners who are already working at the sites. ATSDR will encourage its partners to work with other agencies and programs, such as the Department of Fish and Wildlife, lead poisoning and prevention programs, and country health departments. The proposed activities are responsive to OMB's 2003 Program Assessment Rating Tool (PART) audit recommendations, and in compliance

US Code: 42 USC 104(i) Name of Law: Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA)
  
None

Not associated with rulemaking

  71 FR 65116 11/07/2006
72 FR 34017 06/20/2007
No

Yes
Miscellaneous Actions
No
This is a new data collection.

$275,374
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman

  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.
07/13/2007


© 2025 OMB.report | Privacy Policy