Study of Comprehensive Cancer Control and Tobacco Control Program Partnerships

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
QLCER_Partnership Study_SSB_053111.docx	Supporting Statement B	Uploaded 2011-08-25	Available
Appendix 09_Nondisclosure Agreement.doc	Supplementary Document	Uploaded 2011-08-26	Available
Appendix 11_References.docx	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 10_Oral Consent Script.doc	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 03_Overall Study Flowchart.docx	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 02b Summary of Public Comments.doc	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 01b_ARRA of 2009.pdf	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 01a_Public Health Service Act.doc	Supplementary Document	Uploaded 2011-08-25	Available
Appendix 04_Introductory Email for Prep Call.doc	Supplementary Document	Uploaded 2011-08-25	Available
QLCER_Partnership Study_SSA_080711.docx	Supporting Statement A	Uploaded 2011-08-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
199090	Title Interviews with Tobacco Control Programs	Other-CCC-TCP Partnership Study, TCP/QL Leadership/Program Staff	New
199089	Interviews with State Health Departments	Other-Interview Guide for Health Department Leadership	New
199088	Site Visit Preparation for Cancer Control Programs and Tobacco Control Programs	Other-Guidance	New
199087	Interviews with Comprehensive Cancer Control Programs	Other-CCC-TCP Partnerships Study, CCC Leadership/Program Staff I	New

ICR Details

OMB Control No: 0920-0918	ICR Reference No: 201108-0920-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Study of Comprehensive Cancer Control and Tobacco Control Program Partnerships
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: 01/19/2012
	Date Received in OIRA: 08/31/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2013	12 Months From Approved
Responses	119	0	0
Time Burden (Hours)	114	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This qualitative project will allow CDC to obtain and disseminate information about the current level of communication and collaboration between Comprehensive Cancer Control programs and Tobacco Control Programs in seven selected states. Approval is requested for one year.

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Authorizing Statute(s): PL: Pub.L. 111 - 5 VIII Name of Law: American Recovery and Reinvestment Act of 2009
   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 33302	06/08/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 53136	08/25/2011
Did the Agency receive public comments on this ICR? Yes

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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
Interviews with Comprehensive Cancer Control Programs
Site Visit Preparation for Cancer Control Programs and Tobacco Control Programs
Interviews with State Health Departments
Title Interviews with Tobacco Control Programs

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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	119	0	0	119	0	0
Annual Time Burden (Hours)	114	0	0	114	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 new, one-time information collection. It is one component of a larger Comparative Effectiveness Research (CER) study that also includes a promotion/cessation component.

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Annual Cost to Federal Government: $254,583

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)? Yes

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: 08/31/2011

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