Assessment of Zika Prevention Strategies in the U.S. Virgin Islands

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Intercept Interview with Community Members - USVI	Form and Instruction	New	Available
Intercept Interview with Pregnant Women - USVI	Form and Instruction	New	Available
USVI Pregnant Women_SSA 16NOV2016.docx	Supporting Statement A	Uploaded 2016-11-16	Available
Statement B Nov 6 2016.CLEAN.DOCX	Supporting Statement B	Uploaded 2016-11-09	Available
Att F – Explanation of differences between two zika-related USVI projects (1).docx	Supplementary Document	Uploaded 2016-11-09	Available
Attachment B.60-Day FRN .docx	Supplementary Document	Uploaded 2016-11-09	Available
USVI Signed memo.pdf	Supplementary Document	Uploaded 2016-11-07	Available
Att_A_Section 301 of Public Health Service Act (42 U.S.C. 241).docx	Supplementary Document	Uploaded 2016-11-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224379	Intercept Interview with Community Members - USVI	Form and Instruction	New
224375	Intercept Interview with Pregnant Women - USVI	Form and Instruction	New

ICR Details

OMB Control No: 0920-1147	ICR Reference No: 201611-0920-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 17CR
Title: Assessment of Zika Prevention Strategies in the U.S. Virgin Islands
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 11/17/2016
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/16/2016
	Date Received in OIRA: 11/16/2016
Terms of Clearance: Approved consistent with the understanding that this clearance grants 3 months of data collection. The program will publish 60 and 30 day Federal Register notices and submit a standard ICR for regular OMB review/approval as soon as it is anticipated that the collection may extend beyond the 3 month clearance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	3 Months From Approved
Responses	425	0	0
Time Burden (Hours)	121	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The overarching goal of this project is to engage key audiences in the U.S. Virgin Islands (USVI) regarding a variety of Zika prevention activities (personal protective behaviors and vector control activities) in order to assess the current situation and to inform future action. Information collected in this assessment will be used to help refine communication and vector control plans and guide implementation of activities defined in those plans in order to prevent and control Zika virus in the U.S. Virgin Islands.

Emergency Justfication: Recently, the U.S. Virgin Islands has seen a large jump in cases. Response leaders at the U.S. Virgin Islands Department of Health and CDC have asked the behavioral science team to do a comprehensive assessment of different facets of the response among several audiences in order to help understand the current situation and to inform next steps. The U.S. Virgin Islands has reported 1,425 cases of Zika with 575 laboratory-confirmed cases. Sixty-one of these cases are among pregnant women. Because Zika is an emerging arboviral disease and a sexually transmitted disease that is known to cause microcephaly and other serious birth defects in babies if a pregnant woman is infected during her pregnancy, an urgent assessment of individuals’ Zika prevention strategies is urgently needed to inform the ongoing response in the U.S. Virgin Islands.

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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
Intercept Interview with Community Members - USVI	NA	Intercept Interview with Community Members - USVI
Intercept Interview with Pregnant Women - USVI	NA	Intercept Interview with Pregnant Women - USVI

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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	425	0	0	425	0	0
Annual Time Burden (Hours)	121	0	0	121	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 0920-17CR is a New Emergency ICR related to the Zika Virus response.

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Annual Cost to Federal Government: $156,062

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: 11/16/2016

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