Assessing the Impact of Targeted Training and Technical Assistance Efforts on the Implementation of Comprehensive Cancer Control

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
In-Depth Interview Guide	Form and Instruction	New	Available
Screen Shots of the Web-based Survey (with single option)	Form	New	Available
Screen Shots of the Web-based Survey (with multiple options)	Form	New	Available
Case Study Interview Guide for DP13-1315 Partners	Form and Instruction	New	Available
Case Study Interview Guide for DP13-1314 Partners	Form and Instruction	New	Available
Case Study Interview Guide for DP13-1315 Evaluators	Form and Instruction	New	Available
Case Study Interview Guide for DP13-1314 Evaluators	Form and Instruction	New	Available
Follow-up Case Study Interview Guide for DP13-1315 Program Director or Manager	Form and Instruction	New	Available
Initial Case Study Interview Guide for DP13-1315 Program Director or Manager	Form and Instruction	New	Available
Follow-up Case Study Interview Guide for DP13-1314 Program Director or Manager	Form and Instruction	New	Available
Case Study Interview Guide for DP13-1314 Program Director or Manager	Form and Instruction	New	Available
Worksheet for Identifying Case Study Interviewees	Form and Instruction	New	Available
Att 14_IRB Approval Letter.pdf	Supplementary Document	Uploaded 2017-05-01	Available
Att 13b_In Depth Interview Informed Consent.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 13a_Case Study Interview Informed Consent.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 12_Data collector Non-Disclosure Agreement.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 4_Evaluation Matrix.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 3b_Evaluation Conceptual Framework.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 3a_List of Awardees for DP13-1314 and DP13-1315.docx	Supplementary Document	Uploaded 2017-05-01	Available
Att 2_Federal Register Notice.pdf	Supplementary Document	Uploaded 2017-05-01	Available
Att 1_Authorizing Legislation PHSA.pdf	Supplementary Document	Uploaded 2017-05-01	Available
Part B_17AW_rev 4 06 17.docx	Supporting Statement B	Uploaded 2017-05-01	Available
Part A_17AW_rev 4 10 17.docx	Supporting Statement A	Uploaded 2017-05-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226627	In-depth Interview with Selected Respondents to the Web-based Survey	Form and Instruction	New	In-Depth Interview Guide
226625	Web-based Survey of NCCCP and NSBT Staff and Partners	Form	New	Screen Shots of the Web-based Survey (with single option)
226625	Web-based Survey of NCCCP and NSBT Staff and Partners	Form	New	Screen Shots of the Web-based Survey (with multiple options)
226624	Case Study Interview of DP13-1315 Partner	Form and Instruction	New	Case Study Interview Guide for DP13-1315 Partners
226623	Case Study Interview of DP13-1314 Partner	Form and Instruction	New	Case Study Interview Guide for DP13-1314 Partners
226622	Case Study Interview of DP13-1315 Evaluator	Form and Instruction	New	Case Study Interview Guide for DP13-1315 Evaluators
226620	Case Study Interview of DP13-1314 Evaluator	Form and Instruction	New	Case Study Interview Guide for DP13-1314 Evaluators
226619	Follow-up Case Study Interview of DP13-1315 Program Director or Manager	Form and Instruction	New	Follow-up Case Study Interview Guide for DP13-1315 Program Director or Manager
226618	Initial Case Study Interview of DP13-1315 Program Director or Manager	Form and Instruction	New	Initial Case Study Interview Guide for DP13-1315 Program Director or Manager
226617	Follow-up Case Study Interview of DP13-1314 Program Director or Manager	Form and Instruction	New	Follow-up Case Study Interview Guide for DP13-1314 Program Director or Manager
226616	Initial Case Study Interview of DP13-1314 Program Director or Manager	Form and Instruction	New	Case Study Interview Guide for DP13-1314 Program Director or Manager
226615	Worksheet for Identifying Case Study Interviewees	Form and Instruction	New	Worksheet for Identifying Case Study Interviewees

ICR Details

OMB Control No: 0920-1193	ICR Reference No: 201703-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17AW
Title: Assessing the Impact of Targeted Training and Technical Assistance Efforts on the Implementation of Comprehensive Cancer Control
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: 07/14/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/02/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	24 Months From Approved
Responses	815	0	0
Time Burden (Hours)	231	0	0
Cost Burden (Dollars)	12,451	0	0

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Abstract: The goal of this information collection is to document the implementation of training and technical assistance (TTA) administered by 10 DP13-1314 and DP13-1315 awardees to National Comprehensive Cancer Control Program (NCCCP) and National State-based Tobacco Control (NSBT) grantees and to explore TTA implemented is associated with grant goals. CDC will use findings to monitor TTA and inform the development of future TTA models to effectively support NCCCP and NSBT grantees.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: 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
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 73110	10/24/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 20342	05/01/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 11

table that charts list of burden

IC Title	Form No.	Form Name
Case Study Interview of DP13-1314 Evaluator	N/A	Case Study Interview Guide for DP13-1314 Evaluators
Case Study Interview of DP13-1314 Partner	N/A	Case Study Interview Guide for DP13-1314 Partners
Case Study Interview of DP13-1315 Evaluator	N/A	Case Study Interview Guide for DP13-1315 Evaluators
Case Study Interview of DP13-1315 Partner	N/A	Case Study Interview Guide for DP13-1315 Partners
Follow-up Case Study Interview of DP13-1314 Program Director or Manager	N/A	Follow-up Case Study Interview Guide for DP13-1314 Program Director or Manager
Follow-up Case Study Interview of DP13-1315 Program Director or Manager	N/A	Follow-up Case Study Interview Guide for DP13-1315 Program Director or Manager
In-depth Interview with Selected Respondents to the Web-based Survey	N/A	In-Depth Interview Guide
Initial Case Study Interview of DP13-1314 Program Director or Manager	N/A	Case Study Interview Guide for DP13-1314 Program Director or Manager
Initial Case Study Interview of DP13-1315 Program Director or Manager	N/A	Initial Case Study Interview Guide for DP13-1315 Program Director or Manager
Web-based Survey of NCCCP and NSBT Staff and Partners	N/A, N/A	Screen Shots of the Web-based Survey (with multiple options) ,   Screen Shots of the Web-based Survey (with single option)
Worksheet for Identifying Case Study Interviewees	N/A	Worksheet for Identifying Case Study Interviewees

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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	815	0	0	815	0	0
Annual Time Burden (Hours)	231	0	0	231	0	0
Annual Cost Burden (Dollars)	12,451	0	0	12,451	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: This is a new information collection.

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Annual Cost to Federal Government: $253,976

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: 05/02/2017

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