Research to Reduce Time to Treatment for Heart Attack/Myocardial Infarction for Rural American Indians/Alaska Natives (AI/AN)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att 4. IRB and Tribal Approvals.pdf	Supplementary Document	Uploaded 2008-07-16	Available
Att 3. Advisory Work Group.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 2B. Summary of Public Comments.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 2A. 0920-07BE 60-day FRN 7.31.07.pdf	Supplementary Document	Uploaded 2008-07-16	Available
Attachment 1. 42 USC 241.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 6B. Supplement for Discussion Guide No MI Group.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 5B. Supplement for Discussion Guide MI Group.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 8B. Consent for Individuals Interview.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 7B. Consent Form for Community Leaders Interview.doc	Supplementary Document	Uploaded 2008-07-16	Available
Att 9B. Consent Form for Medical Providers Interview.doc	Supplementary Document	Uploaded 2008-07-14	Available
SS Part A 0920-07BE 07 14 08.doc	Supporting Statement A	Uploaded 2008-07-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
185919	Focus Group with AI/AN Community Members with no Prior History of MI	Other-Focus Group Discussion Guide for Community Members with no	New
185918	Focus Group with AI/AN Community Members with Prior MI	Other-Focus Group Discussion Guide for Prior MI	New
185917	Interview with Individual Tribal Community Members	Other-Interview Guide for Individuals	New
185916	Interview with Community Leaders	Other-Interview Guide for Community Leaders	New
185915	Interview with Medical Care Providers	Other-Interview Guide	New
185914	Interest Form	Other-Interest Form	New

ICR Details

OMB Control No: 0920-0797	ICR Reference No: 200807-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Research to Reduce Time to Treatment for Heart Attack/Myocardial Infarction for Rural American Indians/Alaska Natives (AI/AN)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/08/2009
	Date Received in OIRA: 07/29/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	12 Months From Approved
Responses	544	0	0
Time Burden (Hours)	231	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC proposes to conduct a study to address gaps in knowledge about delays in time to treatment for heart attack/myocardial infarction (MI)in American Indian/Alaska Native communities. Information will be used to develop culturally appropriate health messages that will promote recognition of MI symptoms and the decision to seek prompt medical attention.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act - Research and Investigation
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41757	07/31/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 43240	07/24/2008
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Interview with Community Leaders
Interview with Individual Tribal Community Members
Focus Group with AI/AN Community Members with Prior MI
Focus Group with AI/AN Community Members with no Prior History of MI
Interest Form
Interview with Medical Care Providers

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ICR Summary of Burden

table that charts list of burden

	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	544	0	0	0	544	0
Annual Time Burden (Hours)	231	0	0	0	231	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $108,900

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/29/2008

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