Knowledge, Attitudes, and Practices related to a Domestic Readiness Initiative on Zika Virus Disease

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Zika Readiness Initiative Survey - Puerto Rico Adults	Form and Instruction	Modified	Repair queued
Zika Readiness Initiative Survey - U.S. Domestic Adults	Form and Instruction	Modified	Available
0920-1136 Change Request Justification_10_03_2016_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-10-05	Available
Zika Readiness OMB Supporting Statement B_OMB_revised_10_03_16_clean.docx	Supporting Statement B	Uploaded 2016-10-05	Available
Zika Readiness OMB Supporting Statement A_OMB_revised_10_3_16_clean.docx	Supporting Statement A	Uploaded 2016-10-05	Available
Emergency request memo.pdf	Supplementary Document	Uploaded 2016-09-08	Available
Attachment G - Script for incoming calls.docx	Supplementary Document	Uploaded 2016-09-08	Available
Attachment F - Zika Readiness Voicemail Message.docx	Supplementary Document	Uploaded 2016-09-08	Available
Attachment B - 60-Day Federal Register Notice.docx	Supplementary Document	Uploaded 2016-09-08	Available
Attachment A - Public Health Service Act (42 USC 241) Section 301.pdf	Supplementary Document	Uploaded 2016-09-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223458	Zika Readiness Initiative Survey - Puerto Rico Adults	Form and Instruction	Modified
223456	Zika Readiness Initiative Survey - U.S. Domestic Adults	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1136	ICR Reference No: 201609-0920-020
Status: Historical Active	Previous ICR Reference No: 201609-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1136-16BCY
Title: Knowledge, Attitudes, and Practices related to a Domestic Readiness Initiative on Zika Virus Disease
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/14/2016
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/06/2016
	Date Received in OIRA: 10/06/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	03/31/2017	03/31/2017
Responses	7,200	0	7,200
Time Burden (Hours)	1,440	0	1,440
Cost Burden (Dollars)	0	0	0

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Abstract: An Emergency ICR is being submitted to determine knowledge, attitudes, and practices (KAPs) related to a new Domestic Readiness Initiative on Zika Virus Disease being launched in select regions of the United States (U.S.) mainland and Puerto Rico. The intended use of the data collected is to improve planning, implementation, refinements, and demonstrate outcomes of a Zika Domestic Readiness Initiative communication and education effort.

Emergency Justfication: Due to the urgent nature of this public health emergency, CDC is implementing a Zika prevention communication and education initiative in the continental United States and Puerto Rico. By launching a Domestic Readiness Initiative on Zika health protection and communication, CDC intends to reach audiences with accurate information regarding Zika and motivate them to follow recommended actions to protect themselves. The overall objective of this project is to launch a Zika health protection and communication campaign in response to a growing public health emergency. CDC requests the 60 and 30 day comment periods to be waived for this Zik-related collection.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. 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

Did the Agency receive public comments on this ICR? No

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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
Zika Readiness Initiative Survey - Puerto Rico Adults	NA, NA	Zika Readiness Initiative Questionnaire - English ,   Zika Readiness Initiative Questionnaire - Spanish
Zika Readiness Initiative Survey - U.S. Domestic Adults	NA, NA	Zika Readiness Initiative Questionnaire - English ,   Zika Readiness Initiative Questionnaire - Spanish

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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	7,200	7,200	0	0	0	0
Annual Time Burden (Hours)	1,440	1,440	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is no overall change in Burden Hours associated with this Non-Substantive Change Request. Burden Hours have been redistributed among Respondents.

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Annual Cost to Federal Government: $36,461

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: 10/06/2016

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