Testing and Evaluation of Tobacco Communication Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
National Tobacco Education Campaign: Rough Cut Testing of TV, Print, and Radio Ads	Form	Modified	Available
0920-0910 Change Request 6 4 2013.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-06-05	Available
0920-0910_IC_4_Part B_2012 11 28.docx	Supplementary Document	Uploaded 2012-11-29	Available
0920-0910_IC_4_Part A_2012_11_28.docx	Supplementary Document	Uploaded 2012-11-29	Available
Att 6 (s) Terms Of Use-Terms Conditions.docx	Supplementary Document	Uploaded 2012-11-29	Available
Att 6 (e) Terms Of Use-Terms Conditions.docx	Supplementary Document	Uploaded 2012-11-29	Available
Att 5 (s) Privacy Policies.docx	Supplementary Document	Uploaded 2012-11-29	Available
Att 5 (e) Privacy Policies.docx	Supplementary Document	Uploaded 2012-11-29	Repair queued
Att 4(s) Emails To Participants (in Spanish).docx	Supplementary Document	Uploaded 2012-11-29	Available
Att 4(e) Emails To Participants (in English).docx	Supplementary Document	Uploaded 2012-11-29	Available
0920-0910_IC #2_Part A_Print and Radio Rough Cuts_2012 01 24 (REVISED 2012.02.17).Clean.docx	Supplementary Document	Uploaded 2012-02-22	Available
Att 11. Follow-up Reminder Email to Potential Survey Respondents.html	Supplementary Document	Uploaded 2012-02-22	Available
Attachment 12 Justification.docx	Supplementary Document	Uploaded 2012-02-22	Repair queued
0920-0910_IC _2_Part B_Print and Radio Rough Cuts_2012 01 24.docx	Supplementary Document	Uploaded 2012-02-22	Repair queued
Att 10. Email to Potential Survey Respondents.html	Supplementary Document	Uploaded 2012-02-22	Repair queued
Att 9. HIPoints Privacy Policy.pdf	Supplementary Document	Uploaded 2012-02-22	Available
Att 8. HIPoints Terms of Use.pdf	Supplementary Document	Uploaded 2012-02-22	Available
Att 7. HIPoints Terms & Conditions.pdf	Supplementary Document	Uploaded 2012-02-22	Available
New Harris Poll Online Survey.mht	Supplementary Document	Uploaded 2012-01-12	Repair queued
New Harris Poll Online Survey.mht	Supplementary Document	Uploaded 2012-01-12	Repair queued
Attachment 5 HIPoints Privacy Policy.pdf	Supplementary Document	Uploaded 2012-01-12	Available
Attachment 3 HIPoints Terms Conditions.pdf	Supplementary Document	Uploaded 2012-01-12	Available
Attachment 4 HIPoints Terms of Use.pdf	Supplementary Document	Uploaded 2012-01-12	Available
0920-0910_IC #1TV Rough Cuts 09 2012.docx	Supplementary Document	Uploaded 2012-01-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204969	National Tobacco Education Campaign: Rough Cut Testing of TV, Print, and Radio Ads	Form	Modified
201319	National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of Print and Radio Ads	Instruction	Modified
200757	National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of TV Ads	Instruction	Modified

ICR Details

OMB Control No: 0920-0910	ICR Reference No: 201306-0920-004
Status: Historical Inactive	Previous ICR Reference No: 201109-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 19744
Title: Testing and Evaluation of Tobacco Communication Activities
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 06/11/2013
	Date Received in OIRA: 06/10/2013
Terms of Clearance: This type of increase must be submitted through a revision request. The reasons underlying the original underestimation of respondents must be discussed. Previous terms continue: CDC/OSH will submit a separate Information Collection Request to OMB that outlines the information collections needed to evaluate the ACA-funded tobacco communication campaign. The pre- and post-campaign surveys for campaign evaluation are related to developmental work to be conducted under the MTTCA generic clearance, however, these surveys will be conducted under a separate OMB control number.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	01/31/2015	01/31/2015
Responses	44,922	0	44,922
Time Burden (Hours)	17,325	0	17,325
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests a nonsubstantive change to add 24,046 responses due to a misestimation in the number of respondents required to achieve the required sample size.

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Authorizing Statute(s): None

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

Did the Agency receive public comments on this ICR? Yes

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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
National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of TV Ads
National Tobacco Education Campaign: Rough Cut Testing of TV, Print, and Radio Ads	none, none, none, none, none	Screener for General Pop. and AI/AN ,   Screener for Spanish Speaking Hispanics ,   Screener for Spanish Speaking Hispanics - Spanish ,   Main Questionnaire - English ,   Main Questionnaire - Spanish
National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of Print and Radio Ads

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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: Additional responses are requested as more persons had to be screened to achieve sample sizes than anticipated. There is no change in burden hours or scope of the clearance.

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Annual Cost to Federal Government: $27,506

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]? Yes

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: 06/10/2013

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