Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns--New

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG)	Form	New	Available
Tailoring Gynecologic Cancer Education for Health Care Providers	Form	New	Available
0920-0800 SS Part B 8 5 11_draft.doc	Supporting Statement B	Uploaded 2011-10-19	Available
App E. Reference Questions for Focus Group Guide.doc	Supplementary Document	Uploaded 2011-10-19	Available
0920-0800 Part 2 Screening.docx	Supplementary Document	Uploaded 2011-10-19	Available
0920-0800 Part 2 Focus Groups.docx	Supplementary Document	Uploaded 2011-10-19	Available
App D. Consent Form 8.2.11.doc	Supplementary Document	Uploaded 2011-10-19	Available
App C. Reference Questions for Screening Form 8.05.11.doc	Supplementary Document	Uploaded 2011-10-19	Repair queued
App F. 684 Form Public Health Practice.pdf	Supplementary Document	Uploaded 2011-10-19	Available
App B2. Summary of Public Comments.doc	Supplementary Document	Uploaded 2011-10-19	Available
App B1. 60d FRN.pdf	Supplementary Document	Uploaded 2011-10-19	Available
App A2. Johannas Law.pdf	Supplementary Document	Uploaded 2011-10-19	Available
App A1. PHSA.doc	Supplementary Document	Uploaded 2011-10-19	Available
App D. Consent Form 8.2.11.doc	Supplementary Document	Uploaded 2011-10-19	Available
DCPC OMB 0920-0800 SS Part A 9 27 11.doc	Supporting Statement A	Uploaded 2011-10-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
211763	Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG)	Form	New
211390	Tailoring Gynecologic Cancer Education for Health Care Providers	Form	New
211260	Tailoring Gynecologic Cancer Education for Health Care Providers	Other-Word	New

ICR Details

OMB Control No: 0920-0800	ICR Reference No: 201111-0920-004
Status: Historical Active	Previous ICR Reference No: 200906-0920-015
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns--New
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/28/2011
	Date Received in OIRA: 11/22/2011
Terms of Clearance: Previous terms of clearance continue: This generic clearance for HHS/CDC Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns is approved under the following conditions: 1) HHS/CDC shall use the generic clearance to collect general public and health care professionals data (via focus groups) where the agency seeks to gather information for general service improvement, not for publication or for the purpose of informing significant policy or resource allocation decisions. 2) Focus groups should be of limited size and scope. 3) For individual focus groups, HHS/CDC shall submit a generic IC in ROCIS along with an abbreviated supporting statement in the template agreed to by OMB and HHS/CDC. This statement shall include all relevant information, including a statement of need, intended use of information, description of respondents, information collection procedures, expected response rate, justification for incentive, and estimated burden. 4) OMB will aim to respond with clearance or questions within 10 working days.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2014	30 Months From Approved	01/31/2012
Responses	2,592	0	2,592
Time Burden (Hours)	1,814	0	1,814
Cost Burden (Dollars)	52,843	0	52,843

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Abstract: CDC's Division of Cancer Prevention and Control requests OMB approval for a generic clearance to conduct formative evaluation efforts in order to effectively plan new and/or tailor existing cancer communication campaigns. Information will be collected through focus group discussions involving the general public and health care professionals. Proposed activities will utilize HHS Health Communication Process methodology.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   US Code: 42 USC 247b-17 Name of Law: Gynecologic Cancer Education and Awareness Act, Johanna's Law
  

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 51035	08/17/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 66070	10/25/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Tailoring Gynecologic Cancer Education for Health Care Providers
Tailoring Gynecologic Cancer Education for Health Care Providers	none, none, none	Grp A Focus Group Guide ,   Grp B Focus Group Guide ,   Recruitment Form
Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG)	none, none	Recruitment ,   Focus Group Guide

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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	2,592	2,592	0	0	0	0
Annual Time Burden (Hours)	1,814	1,814	0	0	0	0
Annual Cost Burden (Dollars)	52,843	52,843	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: $500,000

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? 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: 11/22/2011

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