COMMUNITY EVALUATION OF THE NATIONAL DIABETES EDUCATION PROGRAMS DIABETES HEALTHSENSE WEBSITE

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 10 Comparison Participant Recruitment Guide	Form and Instruction	New	Available
Form 9 Intervention Participant Recruitment Guide	Form and Instruction	New	Available
Form 8 Community Educator Post Interview	Form and Instruction	New	Available
Form 7 Community Educator Pre Interview	Form and Instruction	New	Available
Form 6 Participant Posttest	Form and Instruction	New	Available
Form 5 Participant Pretest	Form and Instruction	New	Available
Form 4 Participant Follow-Up Interview	Form and Instruction	New	Available
Form 3 Participant Exit Satisfaction Survey	Form and Instruction	New	Available
Form 2 Participant Posttest	Form and Instruction	New	Available
Form 1 Participant Pretest	Form and Instruction	New	Available
2B - NDEP OMB statement_PartB_032414.doc	Supporting Statement B	Uploaded 2014-03-25	Available
3 - NDEP DHS Research question_methodology summary_110613_OMB30.docx	Supplementary Document	Uploaded 2013-12-27	Available
2A1 - NDEP OMB statement_PartA_Attachment1_121913.docx	Supplementary Document	Uploaded 2013-12-27	Available
2A3 - NDEP OMB statement_PartA_Attachment3_121913.docx	Supplementary Document	Uploaded 2013-12-27	Available
2A2 - NDEP OMB statement_PartA_Attachment2_121913.docx	Supplementary Document	Uploaded 2013-12-27	Available
3B - NDEP DHS Participant Posttest_110613_OMB30.docx	Supplementary Document	Uploaded 2014-01-13	Available
3C - NDEP DHS Participant Exit Satisfaction Survey_091913_OMB30.doc	Supplementary Document	Uploaded 2014-01-13	Available
3B - NDEP DHS Participant Posttest_110613_OMB30.docx	Supplementary Document	Uploaded 2014-01-13	Available
3A - NDEP DHS Participant Pretest_110613_OMB30.docx	Supplementary Document	Uploaded 2014-01-13	Available
2A - NDEP OMB statement_PartA_032414.doc	Supporting Statement A	Uploaded 2014-03-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210075	Comparison Participant Recruitment Guide	Form and Instruction	New	Comparison Participant Recruitment Guide
210074	Intervention Participant Recruitment Guide	Form and Instruction	New	Intervention Participant Recruitment Guide
210073	Community Educator Post Interview	Form and Instruction	New	Community Educator Post Interview
210072	Community Educator Pre-Interview	Form and Instruction	New	Community Educator Pre Interview
210071	Participant Posttest (Adult comparison group participants)	Form and Instruction	New	Participant Posttest
210070	Participant Pretest (Adult Comparison group participants)	Form and Instruction	New	Participant Pretest
210069	Participant Follow-up Interview	Form and Instruction	New	Participant Follow-Up Interview
210068	Participant Exit Satisfaction Survey	Form and Instruction	New	Participant Exit Satisfaction Survey
210067	Participant Posttest (Adult intervention participants)	Form and Instruction	New	Participant Posttest
210066	Participant Pretest (Adult intervention participants)	Form and Instruction	New	Participant Pretest

ICR Details

OMB Control No: 0925-0694	ICR Reference No: 201401-0925-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No: 21241
Title: COMMUNITY EVALUATION OF THE NATIONAL DIABETES EDUCATION PROGRAMS DIABETES HEALTHSENSE WEBSITE
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: 04/07/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/16/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2017	36 Months From Approved
Responses	990	0	0
Time Burden (Hours)	309	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Diabetes Education Program (NDEP) is a partnership of the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) and more than 200 public and private organizations. The long?term goal of the NDEP is to reduce the burden of diabetes and pre-diabetes in the United States, and its territories, by facilitating the adoption of proven strategies to prevent or delay the onset of diabetes and its complications. The program audiences include the public, people at risk for diabetes, people with diabetes and their families, with special emphasis on racial/ethnic populations; health care providers; and payers and purchasers of health care and health care system policy makers. This study will be a multi-component 3-year evaluation of NDEP's Diabetes HealthSense, an online compendium of psychosocial and behavioral resources to support lifestyle changes. The required forms will support the following evaluation tasks: 1) Assessing community educators' experience and satisfaction with NDEP resources such as the Diabetes HealthSense website; 2) Assess the extent to which, through participation in Diabetes HealthSense educational sessions, community educators can increase their knowledge and ability to promote and use NDEP resources; and 3) Assess the extent to which the website, with guided exploration, can facilitate changes in lifestyle to help prevent or manage diabetes. The data collected from this evaluation will provide NDEP with information about how community educators use NDEP-created resources in their communities and whether the Diabetes HealthSense resource has its intended effect on participants. Such data will help inform NDEP's future decisions about the Diabetes HealthSense website, including whether to make changes to Diabetes HealthSense, and whether to invest additional resources to support, promote, or expand this resource.

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 47326	08/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 2458	01/14/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Community Educator Post Interview	8	Community Educator Post Interview
Community Educator Pre-Interview	7	Community Educator Pre Interview
Comparison Participant Recruitment Guide	10	Comparison Participant Recruitment Guide
Intervention Participant Recruitment Guide	9	Intervention Participant Recruitment Guide
Participant Exit Satisfaction Survey	3	Participant Exit Satisfaction Survey
Participant Follow-up Interview	4	Participant Follow-Up Interview
Participant Posttest (Adult comparison group participants)	6	Participant Posttest
Participant Posttest (Adult intervention participants)	2	Participant Posttest
Participant Pretest (Adult Comparison group participants)	5	Participant Pretest
Participant Pretest (Adult intervention participants)	1	Participant Pretest

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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	990	0	0	990	0	0
Annual Time Burden (Hours)	309	0	0	309	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 ICR.

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Annual Cost to Federal Government: $215,000

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: 01/16/2014

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