State Chronic Disease Prevention and Control Programs: Training Needs

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
State Chronic Disease Prevention and Control Programs: Training Needs Form and Instruction
Contact Instrument - NCCDPHP Training Needs Assessment C Contact Instrument.docx Form and Instruction
Survey - NCCDPHP Training Needs Assessment E Instrument Web version.docx Form and Instruction
Att. A Core Competencies.pdf NCCDPHP Core Competencies IC Document
Att. B The Four Domains.pdf Four Domains of Chronic Disease Prevention IC Document
D Instrument Word version.docx Survey - NCCDPHP Training Needs Assessment WORD IC Document
F Invitation email.docx Invitation Email IC Document
G Reminder email.doc Reminder Email IC Document
SHD-TTASNA-SSA 31AUG.docx Supporting Statement A IC Document
SHD-TTASNA-SSB 31AUG.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	State Chronic Disease Prevention and Control Programs: Training Needs	Agency IC Tracking Number:	15BEJ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Contact Instrument - NCCDPHP Training Needs Assessment	C Contact Instrument.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Survey - NCCDPHP Training Needs Assessment	E Instrument Web version.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 357	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	357	357
Annual IC Time Burden (Hours)	156	156
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NCCDPHP Core Competencies	Att. A Core Competencies.pdf	08/26/2015
Four Domains of Chronic Disease Prevention	Att. B The Four Domains.pdf	08/26/2015
Survey - NCCDPHP Training Needs Assessment WORD	D Instrument Word version.docx	08/26/2015
Invitation Email	F Invitation email.docx	08/26/2015
Reminder Email	G Reminder email.doc	08/26/2015
Supporting Statement A	SHD-TTASNA-SSA 31AUG.docx	08/31/2015
Supporting Statement B	SHD-TTASNA-SSB 31AUG.docx	08/31/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.