Field Test of Communication and Marketing Variables for Health Protection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SS PART B .doc.docx	Supporting Statement B	Uploaded 2009-10-20	Available
ATTACHMENT 1 Legal authority.doc	Supplementary Document	Uploaded 2009-10-13	Available
ATTACHMENT 6 WESTAT IRB MEMO.docx	Supplementary Document	Uploaded 2009-10-13	Available
ATTACHMENT 5 PUBLIC COMMENT ON FEDERAL REGISTER.docx	Supplementary Document	Uploaded 2009-10-13	Available
ATTACHMENT 2 60 DAY FEDERAL REGISTER NOTICE.pdf	Supplementary Document	Uploaded 2009-10-13	Available
SS PART A (2).doc.docx	Supporting Statement A	Uploaded 2009-10-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
191178	Field Test Survey Instrument (Web and Telephone)	Other-Web Survey	New
191177	Field Test Screening Instrument	Other-Screener	New

ICR Details

OMB Control No: 0920-0845	ICR Reference No: 200911-0920-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Field Test of Communication and Marketing Variables for Health Protection
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 with change	Conclusion Date: 02/08/2010
	Date Received in OIRA: 11/03/2009
Terms of Clearance: This approval is for developmental work that will be conducted in three steps: cognitive interviews, a series of pilot tests, and a field test. CDC will submit a nonsubstantive change package between the pilot and field testing components. If there are only editorial changes to the wording of the questions, then CDC can proceed to the field test as soon as those changes have been shared with OMB informally. CDC understands that OMB does not consider Knowledge Networks (KN) to be an appropriate frame for defining a representative sample. Thus, approval is only being given for using the results of the KN for the purposes of studying mode effects (phone vs. web-based recruiting and administration).

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2012	12 Months From Approved
Responses	21,182	0	0
Time Burden (Hours)	1,222	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Centers for Disease Control and Prevention aims to develop an instrument that contains a core set of health communication and marketing variables that can be used to monitor and assess health protection behaviors over time, while developing standard measures and advancing health protection goals agency-wide.

---

Authorizing Statute(s): US Code: 42 USC 41 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 14129	03/30/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 53261	10/16/2009
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Field Test Screening Instrument
Field Test Survey Instrument (Web and Telephone)

---

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	21,182	0	0	21,182	0	0
Annual Time Burden (Hours)	1,222	0	0	1,222	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a request for a new data collection.

---

Annual Cost to Federal Government: $496,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 11/03/2009

---