MOVE: Making Our Vitality Evident

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
IRB 041332 Approval Healthy Weight.pdf	Supplementary Document	Uploaded 2013-08-23	Available
0990_MOVE_Section B Statistical Methods.docx	Supporting Statement B	Uploaded 2013-07-19	Available
19133_ID 0990 - MOVE Making Our Vitality Evident.docx	Supporting Statement A	Uploaded 2013-07-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
207834	Post Test Physician's Nurses Survey	Other-test	New
207833	Pre Test Physician's nurses Survey	Other-survey	New
207832	Post -Test Women's Survey	Other-survey	New
207831	Pre-test Women's Survey	Other-survey	New

ICR Details

OMB Control No: 0990-0410	ICR Reference No: 201307-0990-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No: 19133
Title: MOVE: Making Our Vitality Evident
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 with change	Conclusion Date: 08/23/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/22/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2014	36 Months From Approved
Responses	380	0	0
Time Burden (Hours)	56	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office on Women's Health (OWH) and the Department of Health and Human Services (HHS) Coordinating Committee on Lesbian, Gay, Bi-sexual and Transgender (LGBT) Issues has prioritized the collection of health data on LGBT populations. The George Washington University and Whitman Walker Health Clinic's Mautner Project, a community organization that promotes the health and wellness of lesbian and bisexual women, developed "MOVE: Making Our Vitality Evident." This program responds to Goal 1, Strategy 1-2 and Goal 4, Strategy 4-1 of the 2012 IOM report on Accelerating Progress in Obesity Prevention. To achieve Strategy 1-2, two cohorts of 20 women each will participate in a 12 week curriculum that focuses on health and nutrition education, physical activity, and social support. To achieve Strategy 4-1, MOVE will conduct trainings for up to 150 providers on culturally competent care for interacting with and treating obese and overweight lesbian and bisexual patients. The MOVE intervention and evaluation is designed to target women aged 40 and older living in the Washington, D.C. metropolitan area and will last for up to one year.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: 241 Public 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:
	78 FR 17675	03/22/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42951	07/18/2013
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
Post -Test Women's Survey
Post Test Physician's Nurses Survey
Pre Test Physician's nurses Survey
Pre-test Women's Survey

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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	380	0	0	380	0	0
Annual Time Burden (Hours)	56	0	0	56	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: new collection

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Annual Cost to Federal Government: $110,600

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]? 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: 07/22/2013

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