Development and Evaluation of Eagle Books and Youth Eagle Books for American Indians and Alaska Natives (AI/ANs)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Interview for Administrators for Grades 5-8	Form and Instruction	New	Repair queued
Interview for Administrators for Grades K-4	Form and Instruction	New	Repair queued
Interview with Community Health Representatives	Form and Instruction	New	Repair queued
SS_Part B_4 11 2011.doc	Supporting Statement B	Uploaded 2011-04-13	Repair queued
Att H. IRB approval amended.pdf	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att A-2. Authorizing Legislation WIC.pdf	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att A-1. Authorizing Legislation PHSA.pdf	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att B-2. Summary of Public Comments.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att B-1. Federal Register Notice.pdf	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att G-3. Children K-4_Youth Assent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att G-2. Children K-4_Parental Consent.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att G-3. Children K-4_Youth Assent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att G-2. Children K-4_Parental Consent.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att F-3. Parents_Discussion Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att F-2. Parents_Information Sheet.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att E-3. Teachers_Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att E-2. Teachers_Information Sheet.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att E-3. Teachers_Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att E-2. Teachers_Information Sheet.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att D-2. Administrators_Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att D-2. Administrators_Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att C-2. Community Reps_Information Sheet.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
Att C-3. Community Reps_Consent Form.doc	Supplementary Document	Uploaded 2011-04-13	Repair queued
SS_Part A_4 11 2011.doc	Supporting Statement A	Uploaded 2011-04-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197474	Discussion Guide for Children Grades 2-4	Instruction	New
197473	Discussion Guide for Children Grades K-1	Instruction	New
197472	Discussion Guide for Parents of Grades K-4	Instruction	New
197471	Discussion Guide for Teachers Grades 5-8	Instruction	New
197470	Discussion Guide for Teachers Grades K-4	Instruction	New
197469	Interview for Administrators for Grades 5-8	Form and Instruction	New
197468	Interview for Administrators for Grades K-4	Form and Instruction	New
197467	Interview with Community Health Representatives	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201104-0920-017
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Development and Evaluation of Eagle Books and Youth Eagle Books for American Indians and Alaska Natives (AI/ANs)
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: Withdrawn	Conclusion Date: 06/23/2011
	Date Received in OIRA: 04/27/2011
Terms of Clearance: Withdrawn at agency request. Revised package anticipated the week of July 4.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC's Native Diabetes Wellness Program requests OMB approval to assess customer satisfaction, receptivity, involvement, and potential impact of the Eagle Books and Youth Eagle Books.

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Authorizing Statute(s): PL: Pub.L. 108 - 256 204 Name of Law: Child Nutrition and WIC Reauthoritzation
   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:
	76 FR 7856	02/11/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 21747	04/18/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Discussion Guide for Parents of Grades K-4
Discussion Guide for Children Grades K-1
Discussion Guide for Children Grades 2-4
Interview with Community Health Representatives	none	Community Representative Interview Guide
Interview for Administrators for Grades K-4	none	Interview Guide for Administrators for Grades k-4
Interview for Administrators for Grades 5-8	none	Interview guide for administrators for grades 5-8
Discussion Guide for Teachers Grades K-4
Discussion Guide for Teachers Grades 5-8

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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: $222,840

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: 04/27/2011

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