A Comprehensive Evaluation of a Paid Social Media and Mass Media Gynecologic Cancer Campaign

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att 5_IRB Approval Letter.pdf	Supplementary Document	Uploaded 2015-01-12	Available
Att 2b. Summary of Public Comments.doc	Supplementary Document	Uploaded 2015-01-12	Available
Att 2a. 60-day FRN 2 26 2014.pdf	Supplementary Document	Uploaded 2015-01-12	Available
Att 1b. PHSA.DOC	Supplementary Document	Uploaded 2015-01-12	Available
Att 1a. Johannas Law.pdf	Supplementary Document	Uploaded 2015-01-12	Available
IK SS-Part B_10-30_rev 12 31 14.docx	Supporting Statement B	Uploaded 2015-01-12	Available
IK SS-Part A_10 21_rev 12 31 14.docx	Supporting Statement A	Uploaded 2015-01-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214584	Women's Health Survey	Other-WORD	New
214583	Screening for the Women's Health Survey	Other-WORD	New

ICR Details

OMB Control No: 0920-1065	ICR Reference No: 201501-0920-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 14KE
Title: A Comprehensive Evaluation of a Paid Social Media and Mass Media Gynecologic Cancer Campaign
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: Approved without change	Conclusion Date: 05/20/2015
	Date Received in OIRA: 01/22/2015
Terms of Clearance: It should be noted that while the sample recruitment procedures are designed to approximate a nationally representative sample, the limitations associated with online data collection from survey panels require that all results from this information collection be reported with appropriate caution and interpretation. Specifically, although all participants must be invited to participate and cannot volunteer on their own, there may be systematic differences between individuals who choose to join internet surveys and the type of individuals who do not wish to participate in these types of studies over an ongoing timeframe. Therefore, evaluation results must be interpreted with appropriate caution regarding our ability to generalize the findings to the national population of women.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2016	12 Months From Approved
Responses	3,030	0	0
Time Burden (Hours)	838	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC plans to conduct self-administered, web-based surveys in 4 cities to evaluate reach and impact of a media campaign called Inside Knowledge: Get the Facts about Gynecologic Cancer. The target audience is women ages 40-65. All four cities are included in a national media campaign. A supplemental media buy will be conducted in two of the four cities.

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Authorizing Statute(s): US Code: 42 USC 247b-17 Name of Law: Gynecologic Cancer Education and Awareness Act (Johanna;s Law)
   US Code: 42 USC 301 Name of Law: Public Health Service 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 10810	02/26/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 7	01/12/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Women's Health Survey
Screening for the Women's Health Survey

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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	3,030	0	0	3,030	0	0
Annual Time Burden (Hours)	838	0	0	838	0	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: This is a NEW collection (Request for a new OMB Control Number)

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Annual Cost to Federal Government: $874,850

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: 01/22/2015

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