Formative Research to Develop HIV Social Marketing Campaigns for Healthcare Providers

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att 10 Recruitment Firm Privacy Agreement.docx	Supplementary Document	Uploaded 2016-10-13	Available
Att 8 Informed Consent.docx	Supplementary Document	Uploaded 2016-10-13	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-10-13	Available
Att 1 Auth Leg.pdf	Supplementary Document	Uploaded 2016-10-13	Available
SSB.docx	Supporting Statement B	Uploaded 2016-10-13	Available
SSA.doc	Supporting Statement A	Uploaded 2016-10-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223937	Att 9_Provider Screener	Other-WORD	New
223936	Att 7_Materials Testing Guide	Other-WORD	New
223935	Att 6_Concept Testing Guide	Other-WORD	New
223934	Att 5_Message Testing Guide	Other-WORD	New
223933	Att 4c_Exploratory Testing Guide_HIV Prevention: HIV Testing & PrEP	Other-WORD	New
223932	Att 4b_Exploratory Testing Guide_ Transgender Health	Other-WORD	New
223931	Att 4a_Exploratory Testing Guide_Prevention with Positives & Retentiuon in Care	Other-WORD	New
223930	Att 3_Web-Based Survey	Other-WORD	New

ICR Details

OMB Control No: 0920-1182	ICR Reference No: 201610-0920-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-16TZ
Title: Formative Research to Develop HIV Social Marketing Campaigns for Healthcare Providers
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: 05/15/2017
	Date Received in OIRA: 10/14/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved
Responses	2,400	0	0
Time Burden (Hours)	950	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of this study is to conduct in-depth interviews with health care providers to inform the development of provider-focused social marketing campaigns. These activities help us deepen our understanding of providers' interpretation and understanding of HIV prevention science; how providers use guidance or evidence-based approaches in their practices; and how to develop new or enrich existing provider resources to make them more informative, appealing, and usable.

---

Authorizing Statute(s): US Code: 42 USC 301 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 15111	03/21/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 66661	09/28/2016
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Att 3_Web-Based Survey
Att 4a_Exploratory Testing Guide_Prevention with Positives & Retentiuon in Care
Att 4b_Exploratory Testing Guide_ Transgender Health
Att 4c_Exploratory Testing Guide_HIV Prevention: HIV Testing & PrEP
Att 5_Message Testing Guide
Att 6_Concept Testing Guide
Att 7_Materials Testing Guide
Att 9_Provider Screener

---

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	2,400	0	0	2,400	0	0
Annual Time Burden (Hours)	950	0	0	950	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: New collection request for a newOMB Control Number.

---

Annual Cost to Federal Government: $484,033

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: 10/14/2016

---