Awareness and Beliefs About Cancer (ABC) Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 Awarness and Beliefs About Cancer (ABC) Study Survey (Attachment 3)	Form	New	Available
Form 1 ABC Screener (Attachment 2)	Form	New	Available
SSB_ABC_8-20-13.docx	Supporting Statement B	Uploaded 2013-09-10	Available
Cover Memo_8-19-2013.docx	Supplementary Document	Uploaded 2013-09-04	Available
Attach6_Individuals consulted.docx	Supplementary Document	Uploaded 2013-08-20	Available
Attach5_Privacy Act Memo.pdf	Supplementary Document	Uploaded 2013-08-20	Available
Attach4_Ethics-IRB Approval.pdf	Supplementary Document	Uploaded 2013-08-20	Available
Attach1_Background&References.doc	Supplementary Document	Uploaded 2013-08-20	Available
SSA_ABC_9-4-13.docx	Supporting Statement A	Uploaded 2013-09-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208640	Awarness and Beliefs About Cancer (ABC) Study Survey (Attachment 3)	Form	New
208639	ABC Screener (Attachment 2)	Form	New

ICR Details

OMB Control No: 0925-0684	ICR Reference No: 201309-0925-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No: 20347
Title: Awareness and Beliefs About Cancer (ABC) Survey
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: 11/07/2013
	Date Received in OIRA: 09/13/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2014	12 Months From Approved
Responses	10,000	0	0
Time Burden (Hours)	1,334	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The objective of the proposed study is gather data about American adults' awareness and beliefs about cancer. The ultimate goal is to determine how individuals' perceptions of cancer may influence their decisions to report signs and symptoms to health care providers, perhaps affecting the disease stage of diagnosis and the effectiveness of treatment.

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Authorizing Statute(s): US Code: 42 USC 285a-2 Name of Law: Public Health Service Act
   US Code: 42 USC 285 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:
	78 FR 36788	06/19/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 55264	09/10/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
ABC Screener (Attachment 2)	1	ABC Survey-Screener
Awarness and Beliefs About Cancer (ABC) Study Survey (Attachment 3)	2	Awareness and Beliefs about Cancer (ABC) Study 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	10,000	0	0	10,000	0	0
Annual Time Burden (Hours)	1,334	0	0	1,334	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 information collection.

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Annual Cost to Federal Government: $360,000

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? 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: 09/13/2013

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