Enhancing Dialogue and Execution of Dust Reduction Behaviors through Workgroup Communication

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Mine Worker Focus Group Worksheet	Form	New	Available
Current Controls to Reduce Respirable Dust Exposure for Workers	Form	New	Available
Pre/Post Mine Worker Survey	Form	New	Available
Controls to Reduce Respirable Dust Exposure Assessment Worksheet	Form	New	Available
Att L IRB Approval Letter.pdf	Supplementary Document	Uploaded 2015-06-08	Available
Att K_Informed Consent for Management.docx	Supplementary Document	Uploaded 2015-06-08	Available
Att J_Informed Consent for Workers.docx	Supplementary Document	Uploaded 2015-06-08	Available
Att B 60 FRN.pdf	Supplementary Document	Uploaded 2015-06-08	Available
Att A - Federal Mine Safety Health act of 1977.doc	Supplementary Document	Uploaded 2015-06-08	Available
PDM Workgroups ICR Section B 12.29.15.docx	Supporting Statement B	Uploaded 2016-01-08	Available
PDM Workgroups ICR Section A 1 07 16docx.docx	Supporting Statement A	Uploaded 2016-01-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
216922	Mine Worker Focus Group Worksheet	Form	New	Mine Worker Focus Group Worksheet
216921	Controls to Reduce Dust Exposure Worksheet for Workers	Form	New	Current Controls to Reduce Respirable Dust Exposure for Workers
216920	Mine Worker Focus Group Guide	Instruction	New
216919	Pre-Post Mine Worker Survey	Form	New	Pre/Post Mine Worker Survey
216918	Mine Worker Recruitment Script	Instruction	New
216917	Controls to Reduce Exposure Worksheet for Management	Form	New	Controls to Reduce Respirable Dust Exposure Assessment Worksheet
216916	Worksite Leadership Interview and Focus Group Guide	Instruction	New
216915	Mine Recruitment and Participation Script	Instruction	New

ICR Details

OMB Control No: 0920-1094	ICR Reference No: 201505-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15LB
Title: Enhancing Dialogue and Execution of Dust Reduction Behaviors through Workgroup Communication
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 with change	Conclusion Date: 01/13/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/11/2015
Terms of Clearance: Approved consistent with OMB’s understanding that NIOSH will use this study to make recommendations about communication approaches that facilitate feedback to miners. Information collected will not be employed to make recommendations about changes in miner behavior that is designed to ultimately reduce exposure.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2019	36 Months From Approved
Responses	515	0	0
Time Burden (Hours)	163	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Project purpose is to determine and assess the impact of a communication/technology pre/post longitudinal case study intervention on (1) workers' health/safety behaviors, including those that lower exposure to respirable coal dust; (2) workers' perceptions of their organizations' health and safety values; and (3) the types of health and safety management practices identified and utilized by mine site leaders to support workers' health/safety behaviors.

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Authorizing Statute(s): PL: Pub.L. 91 - 173 501 Name of Law: Federal Mine Safety and Health Act
   PL: Pub.L. 95 - 164 501 Name of Law: Federal Mine Safety and Health 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:
	80 FR 3598	01/23/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 31382	06/02/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Controls to Reduce Dust Exposure Worksheet for Workers	none	Current Controls to Reduce Respirable Dust Exposure for Workers
Controls to Reduce Exposure Worksheet for Management	none	Controls to Reduce Respirable Dust Exposure Assessment Worksheet
Mine Recruitment and Participation Script
Mine Worker Focus Group Guide
Mine Worker Focus Group Worksheet	none	Mine Worker Focus Group Worksheet
Mine Worker Recruitment Script
Pre-Post Mine Worker Survey	none	Pre/Post Mine Worker Survey
Worksite Leadership Interview and Focus Group Guide

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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	515	0	0	515	0	0
Annual Time Burden (Hours)	163	0	0	163	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 ICR. Burden totals are slightly off due to rounding.

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Annual Cost to Federal Government: $58,251

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: 06/11/2015

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