Supporting Statement B

PUI-SSB.docx

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

Supporting Statement B

OMB: 0920-0879

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State, Territorial, and Local Health Department Preparedness for Persons under Investigation for Ebola Virus Disease


OSTLTS Generic Information Collection Request

OMB No. 0920-0879



Supporting Statement – Section B




Submitted: 10/3/2014






Program Official/Project Officer


Michelle Chevalier and Charnetta Smith

Epidemic Intelligence Service (EIS) Officers

Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention

1600 Clifton Road, NE, Mailstop D18, Atlanta, GA 30333

404-553-7582

[email protected] (Michelle Chevalier) and [email protected] (Charnetta Smith)








Section B – Data Collection Procedures


  1. Respondent Universe and Sampling Methods


The respondent universe consists of the Health Departments of 55 state, territorial and local health departments lead epidemiologists (50 states, District of Columbia, 1 territory (Puerto Rico) and 3 cities (NYC, Chicago, Los Angeles)). The respondents are lead Epidemiologists or designated as other titles such as health scientists, or medical officers acting in their official capacities. The state, territorial, and city health departments will be stratified by:

  • Geography: distribution across different regions of the United States, grouped by:

    1. Northeast – Connecticut, Maine, Massachusetts, New Hampshire, New York, New York City, New Jersey, Pennsylvania, Rhode Island, Vermont

    2. Midwest – Indiana, Illinois, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin, Chicago

    3. Southeast – District of Columbia, Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, West Virginia

    4. Southwest - Arizona, New Mexico, Oklahoma, Texas

    5. West – Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, Oregon, Utah, Washington, Wyoming, Los Angeles


  1. Procedures for the Collection of Information


The respondents will be sent an email notification with a link to the assessment (see Attachment C—Notification Email). The assessment will remain open for one week to ensure respondents have adequate time for completion. Email reminders will be sent to non-responders on day 3 and day 6 of the assessment open period (see Attachment D & E—Reminder Emails).

  1. Methods to Maximize Response Rates Deal with Nonresponse


Email notification and reminder emails will be sent to maximize response rates. An email reminder will be sent on day 3 and day 6 of the assessment’s open period (see Attachment D & E—Reminder Emails).












  1. Test of Procedures or Methods to be Undertaken


The web-based assessment was pilot tested by 4 public health professionals. Feedback was used to refine questions, ensure the clarity of questions, and establish the estimated time required to complete the assessment. In the pilot test, the average time to complete the instrument including time for reviewing instructions, gathering needed information and completing the instrument, was approximately 10 minutes. Based on these results, the estimated time range for actual respondents to complete the instrument is 8-12 minutes. For the purposes of estimating burden hours, the upper limit of this range (i.e., 12 minutes) is used.


  1. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data


Two CDC staff members will be responsible for majority of the data collection and analysis activities.


Name: Michelle Chevalier

Title: EIS Officer

Phone: 770-488-4634

Email: [email protected]


Name: Charnetta Smith

Title: EIS officer

Phone: 404-639-4653

Email: [email protected]



LIST OF ATTACHMENTS – Section B


C. Notification Email

D. Reminder Email Day 3

E. Reminder Email Day 6


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