Information Collection

Usability and Needs Assessment of CDC's State, Tribal, Local, and Territorial Gateway Website

IC 228708 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment B Questionnaire Information Collection Instrument MS Word Version.docx	Other-Reference document: WORD versi
Attachment D Card Sorting Information Collection Instrument MS Word Version.docx	Other-Reference document: WORD versi
STLT Gateway Website Assessment Questionnaire Attachment C Questionnaire Information Collection Instrument Web Version.docx	Form and Instruction
Card Sorting Assessment Instrument for the STLT Gateway Attachment E Card Sorting Information Collection Instrument.pdf	Form and Instruction
UX-OSTLTS-SSA.docx Supporting Statement Part A	IC Document
UX-OSTLTS-SSB.docx Supporting Statement Part B	IC Document
Attachment A STLT Gateway Screenshot.pdf Screenshot of the STLT Gateway	IC Document
Attachment F Calculating Average Hourly Wages for STLT Health Professional Respondent Burden (for Table A-12).docx Method Used to Estimate Average Hourly Wage	IC Document
Attachment G Questionnaire Invitation.docx Questionnaire Invitation	IC Document
Attachment H Questionnaire Reminder.docx Questionnaire Reminder	IC Document
Attachment I Card Sorting Invitation.docx Card Sorting Invitation	IC Document
Attachment J Card Sorting Reminder.docx Card Sorting Reminder	IC Document

IC Title:

Usability and Needs Assessment of CDC's State, Tribal, Local, and Territorial Gateway Website

Agency IC Tracking Number:

0920-18CH

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Reference document: WORD version of Web Quesionnaire Content			Attachment B Questionnaire Information Collection Instrument MS Word Version.docx	No		Paper Only
Form and Instruction	n/a	Card Sorting Assessment Instrument for the STLT Gateway	Attachment E Card Sorting Information Collection Instrument.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	STLT Gateway Website Assessment Questionnaire	Attachment C Questionnaire Information Collection Instrument Web Version.docx	Yes	Yes	Fillable Fileable
Other-Reference document: WORD version of Card Sorting Instrument Content			Attachment D Card Sorting Information Collection Instrument MS Word Version.docx	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,913

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,913	2,913
Annual IC Time Burden (Hours)	576	576
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Part A	UX-OSTLTS-SSA.docx	10/18/2017
Supporting Statement Part B	UX-OSTLTS-SSB.docx	10/18/2017
Screenshot of the STLT Gateway	Attachment A STLT Gateway Screenshot.pdf	10/18/2017
Method Used to Estimate Average Hourly Wage	Attachment F Calculating Average Hourly Wages for STLT Health Professional Respondent Burden (for Table A-12).docx	10/18/2017
Questionnaire Invitation	Attachment G Questionnaire Invitation.docx	10/18/2017
Questionnaire Reminder	Attachment H Questionnaire Reminder.docx	10/18/2017
Card Sorting Invitation	Attachment I Card Sorting Invitation.docx	10/18/2017
Card Sorting Reminder	Attachment J Card Sorting Reminder.docx	10/18/2017

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