Community-based Tick Control for the Prevention of Rocky Mountain Spotted Fever in Hermosillo, Mexico

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
KAP Survey (Pre/Post)	Form and Instruction	New	Available
Household Registration	Form and Instruction	New	Available
Tick Prevention Hermosillo Mexico_Supporting Statement A 3-28-2016.docx	Supporting Statement A	Uploaded 2016-03-30	Available
Att. E--KAP_consent.docx	Supplementary Document	Uploaded 2016-01-19	Available
Attachment G -- Fwdpublic comment on federal register.pdf	Supplementary Document	Uploaded 2016-01-19	Available
Att. F--BIOETHICAL APPROVAL DIC21.2015.pdf	Supplementary Document	Uploaded 2016-01-19	Available
Tick Prevention Hermosillo Mexico_Supporting Statement B 3-28-2016.docx	Supporting Statement B	Uploaded 2016-03-30	Available
Att. A-- Authorizing LegislationT42 section 241.doc	Supplementary Document	Uploaded 2016-01-07	Available
Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-01-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
219606	KAP Survey (Pre/Post)	Form and Instruction	New
219605	Household Registration	Form and Instruction	New

ICR Details

OMB Control No: 0920-1110	ICR Reference No: 201601-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16CP
Title: Community-based Tick Control for the Prevention of Rocky Mountain Spotted Fever in Hermosillo, Mexico
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: 03/30/2016
	Date Received in OIRA: 01/20/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved
Responses	2,100	0	0
Time Burden (Hours)	700	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Rickettsial Zoonoses Branch (RZB) requests approval of a public health intervention assessment tool to demonstrate the efficacy and impact of public health research related to the prevention of Rocky Mountain spotted fever [RMSF] in Hermosillo, Mexico. These activities include monitoring cases, conducting tick control interventions, and performing participant surveys to assess the knowledge, attitudes, and practices relating to tick control and prevention.

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Authorizing Statute(s): US Code: 42 USC 264 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:
	80 FR 69680	11/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 2867	01/19/2016
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
Household Registration	NA	Household Questionnaire
KAP Survey (Pre/Post)	NA	KAP Questionnaire

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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	2,100	0	0	2,100	0	0
Annual Time Burden (Hours)	700	0	0	700	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: Submission of 0920-16CP is a New ICR.

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Annual Cost to Federal Government: $83,500

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: 01/20/2016

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