Improving the Understanding of Traumatic Brain Injury through Policy and Program Evaluation Research

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Injured Athlete Parent Interview	Form	New	Repair queued
Injured Athlete Follow-up Interview	Form	New	Repair queued
Parent Weekly Report	Form	New	Repair queued
Athlete Weekly Report	Form	New	Source copy available
Pre-season Parent Survey	Form	New	Repair queued
Pre-season Athlete Survey	Form	New	Repair queued
Pre-season Coach Survey	Form	New	Repair queued
AttachM - CSR USYSA Agreement.pdf	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachL IRB Approved letter.pdf	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachK_Invitation _rev9-22.docx	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachJ_Flyer_rev9-19.docx	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachI_Advance Notice letter from USYSA_rev9-19.docx	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachB_Public Comment.docx	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachB-60 day published notice_2014-09763.pdf	Supplementary Document	Uploaded 2014-09-29	Repair queued
AttachA-Authorizing Legislation_rev7-15.docx	Supplementary Document	Uploaded 2014-09-29	Repair queued
SSB_R9-23.docx	Supporting Statement B	Uploaded 2014-09-29	Repair queued
SSA_R10-0924.docx	Supporting Statement A	Uploaded 2014-09-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
213312	Injured Athlete Parent Interview	Form	New
213311	Injured Athlete Follow-up Interview	Form	New
213310	Parent Weekly Report	Form	New
213308	Athlete Weekly Report	Form	New
213307	Pre-season Parent Survey	Form	New
213306	Pre-season Athlete Survey	Form	New
213305	Pre-season Coach Survey	Form	New

ICR Details

OMB Control No:	ICR Reference No: 201409-0920-015
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 14VK
Title: Improving the Understanding of Traumatic Brain Injury through Policy and Program Evaluation Research
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 01/07/2015
	Date Received in OIRA: 10/09/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Sports-related concussions are common injuries among youth and have potentially serious consequences. As a result of concerns about long-term consequences of athletes playing with concussive symptoms, 49 states and the District of Columbia have enacted legislation related to the treatment and management of youth athletes with suspected concussions. Despite almost universal enactment of state laws regarding youth sports–related concussions, no national study has yet examined the effectiveness of these efforts in improving management of such concussions. The purpose of this study and data collection will be to assess the effectiveness of state laws in reducing the number of youth athletes who return to play with concussion symptoms, the general knowledge and understanding of concussions, and the effectiveness of education and training about concussions. Pre-season surveys will be administered to coaches, athletes and parents to collect information about concussion and TBI knowledge, attitudes, and behaviors; history of concussions; and use and awareness of concussion education materials.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

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 24431	04/30/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 59271	10/01/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Pre-season Coach Survey	none	Pre-season Coach Survey
Pre-season Parent Survey	none	Pre-season Parent Survey
Athlete Weekly Report	none	Athlete Weekly Report
Injured Athlete Parent Interview	none	Injured Athlete Parent Interview
Pre-season Athlete Survey	none	Pre-season Athlete Survey
Parent Weekly Report	none	Parent Weekly Report
Injured Athlete Follow-up Interview	none	Injured Athlete Interview

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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: $707,281

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: 10/09/2014

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