Lyme and other Tickborne Diseases Knowledge, Attitude, and Practice Surveys

Forms and Documents

Document Name	Status
Form 0920-1150 Lyme and Other Tickborne Diseases Knowledge, Attitude, and Practice Surveys Form and Instruction	New
Form 0920-1150 Knowledge, Attitudes, and Practices of Healthcare Professionals Working in Schools Regarding Tickborne Disease Prevention and Lyme Disease in New York State and Maryland Form and Instruction	New
Form 0920-1150 Nature and Availability of Commercial Tick Control Services Survey for New York and Pennsylvania Form and Instruction	New
Survey of Pet Owners Encountering Ticks (PETS) in Lyme Disease Endemic Areas Form and Instruction	New
Nature and Availability of Commercial Tick Control Services Survey Form and Instruction	New
Att. 2b - Public comment.pdf Supplementary Document	2016-08-30
Att 9 - PCO Survey.doc Supplementary Document	2016-08-30
Att 8 - Daily Survey.doc Supplementary Document	2016-08-30
Att 7 - Final Survey.doc Supplementary Document	2016-08-30
Att 6 - Monthly Survey.doc Supplementary Document	2016-08-30
Att 5 - Introductory Survey.doc Supplementary Document	2016-08-30
Att 4 - Consent Form.doc Supplementary Document	2016-08-30
Att 3 - Screening Instrument.doc Supplementary Document	2016-08-30
Att 2 - 60-day FRN.pdf Supplementary Document	2016-08-30
Att 1 - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document	2016-08-30
Supporting Statement B_TBD KAP Surveys 02DEC2016.docx Supporting Statement B	2016-12-05
Supp Statement A_TBD KAP Surveys 02DEC2016.docx Supporting Statement A	2016-12-05

IC Document Collections

IC ID	Document Title	Status
236577	Lyme and Other Tickborne Diseases Knowledge, Attitude, and Practice Surveys Form and Instruction	New
235465	Knowledge, Attitudes, and Practices of Healthcare Professionals Working in Schools Regarding Tickborne Disease Prevention and Lyme Disease in New York State and Maryland Form and Instruction	New
229491	Nature and Availability of Commercial Tick Control Services Survey for New York and Pennsylvania Form and Instruction	New
228559	Survey of Pet Owners Encountering Ticks (PETS) in Lyme Disease Endemic Areas Form and Instruction	New
227045	Nature and Availability of Commercial Tick Control Services Survey Form and Instruction	New

ICR Details

OMB Control No: 0920-1150	ICR Reference No: 201606-0920-021
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-16APN
Title: Lyme and other Tickborne Diseases Knowledge, Attitude, and Practice Surveys
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: 12/09/2016
	Date Received in OIRA: 08/31/2016
Terms of Clearance: Collections submitted under this Generic are not designed to develop incidence or prevalence estimates. Information gathered under this OMB clearance will not be used for the purpose of substantially informing influential policy decisions, but are intended to inform future TBD prevention trials. All genICs will include a full SSA (and SSB if necessary) that clearly describes the need underlying the frequency of the collection and evidence supporting any incentives offered.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved
Responses	2,313,000	0	0
Time Burden (Hours)	296,490	0	0
Cost Burden (Dollars)	6,722,413	0	0

---

Abstract: It is the goal of the Division of Vector-borne diseases (DVBD) to conduct surveys to evaluate knowledge, attitutes, and practices regarding ticks and tickborne diseases (TBDs) among residents and businesses offering pest control services in Lyme disease endemic areas of the US. The survey results will inform the implementation of future TBD prevention interventions.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 36919	06/08/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 59628	08/30/2016
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Knowledge, Attitudes, and Practices of Healthcare Professionals Working in Schools Regarding Tickborne Disease Prevention and Lyme Disease in New York State and Maryland	0920-1150, 0920-1150	HPWS Survey (online) ,   HPWS Survey (mail)
Lyme and Other Tickborne Diseases Knowledge, Attitude, and Practice Surveys	0920-1150, 0920-1150	Main Survey ,   Survey Screener
Nature and Availability of Commercial Tick Control Services Survey	NA	Nature and Availability of Commercial Tick Control Services: A Survey of the Pest Management Industry - Screenshot
Survey of Pet Owners Encountering Ticks (PETS) in Lyme Disease Endemic Areas	n/a	Pet Owners Encountering Ticks (PETs) Survey
Nature and Availability of Commercial Tick Control Services Survey for New York and Pennsylvania	0920-1150, 0920-1150	Nature and Availability of Commercial Tick Control Services Survey for New York and Pennsylvania (PA) ,   Nature and Availability of Commercial Tick Control Services Survey for New York and Pennsylvania (NY)

---

ICR Summary 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	2,313,000	0	0	2,313,000	0	0
Annual Time Burden (Hours)	296,490	0	0	296,490	0	0
Annual Cost Burden (Dollars)	6,722,413	0	0	6,722,413	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 0920-16APN is a New (Generic) ICR. Burden estimates are for three (3) years.

---

Annual Cost to Federal Government: $629,000

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

---

Common Form ICR:  No

---

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: 08/31/2016

---