Recruitment and Screening for the Insight into Determination of Exceptional Aging and Longevity (IDEAL) Study (NIA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Consent Booklet and Form	Form and Instruction	New	Available
Form 1 IDEAL screening exam	Form and Instruction	New	Available
Form 1 IDEAL telephone screener Part 2	Form and Instruction	New	Available
Form 1 IDEAL telephone screener Part 1	Form and Instruction	New	Available
Form 3 Phone Questionnaire	Form and Instruction	Removed	Available
Form 2 Physical Exam	Form and Instruction	Removed	Available
Form 1 Telephone Interview	Form and Instruction	Removed	Available
Attachment 11 IDEAL NIEHS Approval letter.pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 10 IDEAL BLSA PIA.pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 6 Previsit Confirmation letters.pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 9 IDEAL CMS Mailing Materials.pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 4 IDEAL recruitment brochure and postcard.pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 3 IDEAL recruitment poster (2).pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 2 IDEAL organizational recruitment letters (2).pdf	Supplementary Document	Uploaded 2014-07-25	Available
Attachment 1 IDEAL recruitment presentation.pdf	Supplementary Document	Uploaded 2014-07-25	Available
IDEAL Supporting Statement B_06_2014 CR 6-9.docx	Supporting Statement B	Uploaded 2014-07-25	Available
IDEAL Supporting Statement A_07_2014 with requested edits 9-30.docx	Supporting Statement A	Uploaded 2014-10-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212478	Attachment 8 Consent Booklet and Form	Form and Instruction	New	Consent Booklet and Form
212477	Attachment 7 IDEAL screening exam	Form and Instruction	New	IDEAL screening exam
212476	Attachment 5b IDEAL telephone screener Part 2	Form and Instruction	New	IDEAL telephone screener Part 2
212475	Attachment 5a IDEAL telephone screener Part 1	Form and Instruction	New	IDEAL telephone screener Part 1
195897	Individuals	Form and Instruction	Removed	Phone Questionnaire
195897	Individuals	Form and Instruction	Removed	Physical Exam
195897	Individuals	Form and Instruction	Removed	Telephone Interview

ICR Details

OMB Control No: 0925-0631	ICR Reference No: 201407-0925-006
Status: Historical Active	Previous ICR Reference No: 201102-0925-003
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Recruitment and Screening for the Insight into Determination of Exceptional Aging and Longevity (IDEAL) Study (NIA)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/06/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/19/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved
Responses	900	0	0
Time Burden (Hours)	333	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Longevity combined with good health and functionality at the end of life represents a common goal. Although research has examined correlates of long life and functional decline, we still know relatively little about why certain individuals live in excellent health into their eighties while others succumb to failing health at much younger ages. Understanding the mechanisms important to ideal aging may provide new opportunity for health promotion and disability prevention is this rapidly growing segment of the population. The purpose of IDEAL (Insight into the Determinants of Exceptional Aging and Longevity) is to recruit into the Baltimore Longitudinal Study on Aging (BLSA) exceptionally long lived and healthy individuals and to learn what makes them so resilient and resistant to disease and disability, and to identify potential interventions that may contribute to the IDEAL condition. By enrolling the IDEAL cohort in the BLSA their biologic, physiologic, behavioral and functional characteristics will be evaluated using the same methods used with the current cohort who will serve as a type of control group. The first aim is to identify factors and characteristics that distinguish IDEAL from non-IDEAL individuals. We intend to compare the two groups to identify factors that discriminate IDEAL aging from non-IDEAL aging individuals. The second aim is to identify physiological, environmental and behavioral characteristics that are risk factors for losing the IDEAL condition over several years or longer. We postulate that the mechanisms of extreme longevity probably differ from those associated with delay or escape from disease and disability. As is customary in the BLSA, we plan to follow this cohort for life with yearly visits.

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Authorizing Statute(s): PL: Pub.L. 93 - 296 88 Name of Law: Research on Aging 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:
	79 FR 18569	04/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 44811	08/01/2014
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
Attachment 5a IDEAL telephone screener Part 1	1	IDEAL telephone screener Part 1
Attachment 5b IDEAL telephone screener Part 2	1	IDEAL telephone screener Part 2
Attachment 7 IDEAL screening exam	1	IDEAL screening exam
Attachment 8 Consent Booklet and Form	1	Consent Booklet and Form
Individuals	1, 2, 3	Telephone Interview ,   Physical Exam ,   Phone Questionnaire

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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	900	0	0	2,400	-1,500	0
Annual Time Burden (Hours)	333	0	0	1,034	-701	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: reinstating ICR that was discontinued

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Annual Cost to Federal Government: $47,130

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: 08/19/2014

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