Translation and Dissemination of Promising Community Interventions for Preventing Obesity

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Deliberative Poll on Obesity Prevention and Control	Form	New	Repair queued
Discussion Group Confirmation	Form and Instruction	New	Repair queued
Discussion Groups	Form and Instruction	New	Repair queued
Supporting Statement Delib Polling_Part B_1 100908.doc	Supporting Statement B	Uploaded 2010-09-16	Repair queued
Attachment 9_Expert Panel List.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 8_Privacy Policy for Questionnaire.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 7_AED Data Security Policy.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 6_IRB approval.pdf	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 5b_Pop-Up Invitation for Questionnaire.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attach 5a_Email Pop-up Invitation.pdf	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 2b_Public Comments and CDC Response.docx	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 2a_Federal Register Notice.pdf	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 1_Public Health Service Act.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attach 4a_Consent Form for Questionnaire Only Respondents.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 3b_Discussion Group Reminder Email.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Attachment 3a_Consent Form for Discussion Groups.doc	Supplementary Document	Uploaded 2010-09-16	Repair queued
Supporting Statement Delib Polling_ Part A_1 100908.doc	Supporting Statement A	Uploaded 2010-09-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194804	Deliberative Poll on Obesity Prevention and Control	Form	New
194803	Discussion Group Briefing Material	Instruction	New
194802	Discussion Group Confirmation	Form and Instruction	New
194801	Discussion Groups	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201010-0920-002
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Translation and Dissemination of Promising Community Interventions for Preventing Obesity
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: Improperly submitted	Conclusion Date: 01/05/2011
	Date Received in OIRA: 10/06/2010
Terms of Clearance: Please resubmit this collection once the Supporting Statements have been completed in accordance with OMB's and HHS guidelines. We will waive the 60 day FR notice, but request that CDC publish a revised 30-day notice consistent with these improvements to the supporting statement (e.g., specific goals of this project, design, and revised burden table)

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Obesity is a contributing factor for numerous chronic disease conditions, and has a substantial impact on health care costs. CDC plans to collect information to identify promising practices for preventing and controlling obesity. Information will be collected from the general public through on-line discussion groups and surveys to assess respondents' knowledge, attitudes, and beliefs about various strategies. The information will be used to develop public messages and campaigns.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

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:
	75 FR 25861	05/10/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 57959	09/23/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Discussion Group Briefing Material
Deliberative Poll on Obesity Prevention and Control	None	Questionnaire
Discussion Groups	none	Discussion Group Moderator's Guide
Discussion Group Confirmation	none	Confirmation Email and Instructions

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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 new ICR.

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Annual Cost to Federal Government: $212,168

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? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 10/06/2010

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