SEARCH for Diabetes in Youth Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Initial Participant Survey - Child Prevalent Case	Form	New	Available
Initial Participant Survey - Adult Prevalent Case	Form	New	Available
Specimen Collection Form	Form	Modified	Available
Physical Examination Form	Form	Modified	Available
Medications Inventory	Form	Modified	Available
Initial Participant Survey - Incident Case Young Adult version (paper)	Form	Modified	Available
Initial Participant Survey - Incident Case Young Adult Version (screen shots)	Form	Modified	Available
Initial Participant Survey - Incident Case Child Version (Paper)	Form	Modified	Repair queued
Initial Participant Survey - Incident Case Child Version (screen shots)	Form	Modified	Available
30dy170904 Published.pdf	Supplementary Document	Uploaded 2017-07-21	Available
Att 11_published article describing SEARCH methods.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 12_Capture_Recapture Technical Report.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 9_All Sites IRB Approved Consent Assent.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 7 IRB Approvals.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 6 List of Experts Consulted.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Att 3_SEARCH_StudySites and CoordinatingCenter.docx	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 2a_60 day Federal Registry Notice.pdf	Supplementary Document	Uploaded 2017-07-19	Available
SEARCH for Diabetes (Youth) SupSta B.docx	Supporting Statement B	Uploaded 2017-07-21	Available
Att 10_Data Use Agreements.pdf	Supplementary Document	Uploaded 2017-07-19	Available
Attachment 8_SEARCH 4 Certificate of Confidentiality 3_25_2016.pdf	Supplementary Document	Uploaded 2017-07-21	Available
Attachment 5 Uses of SEARCH data and publications.doc	Supplementary Document	Uploaded 2017-07-19	Available
Att 1_Authorizing Legislation.doc	Supplementary Document	Uploaded 2017-07-19	Available
SEARCH for Diabetes (Youth) SupSta A clean 10172017.docx	Supporting Statement A	Uploaded 2017-10-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227648	SEARCH Initial Participant Survey - Prevalence	Form	New	Initial Participant Survey - Child Prevalent Case
227648	SEARCH Initial Participant Survey - Prevalence	Form	New	Initial Participant Survey - Adult Prevalent Case
211580	SEARCH Health Questionnaire (Youth )	Other-WORD	Removed
211579	SEARCH Food Frequency Questionnaire	Other-PDF	Removed
197884	SEARCH Specimen Collection Form	Form	Modified	Specimen Collection Form
197883	SEARCH Physical Examination	Form	Modified	Physical Examination Form
197882	Peds QL Diabetes Module	Other-WORD	Removed
197881	SEARCH Diabetes Related Family Conflict Survey	Other-WORD	Removed
197880	SEARCH Pathology Notificaiton (Retinal Photo)	Other-WORD	Removed
197879	SEARCH Tanner Stage	Other-WORD	Removed
197878	SEARCH Supplemental Questionnaire	Other-WORD	Removed
197877	SEARCH Low Blood Surgar Survey	Other-WORD	Removed
197876	SEARCH Diabetes Eating Problem Survey (DEPS-R)	Other-PDF	Removed
197875	SEARCH Michigan Neuropathy Screening Instrument (MNSI)	Other-PDF	Removed
197874	SEARCH PedsQL	Other-PDF	Removed
197873	SEARCH Quality of Care Survey (Feb 2014)	Other-PDF	Removed
197871	SEARCH CES-Depression	Other-PDF	Removed
197869	SEARCH Health Questionnaire (Parent_Feb 2014) Cohort Study	Other-PDF	Removed
197865	SEARCH Medication Inventory (Incident Case)	Form	Modified	Medications Inventory
197864	SEARCH - Initial Participant Survey - Incident	Form	Modified	Initial Participant Survey - Incident Case Young Adult version (paper)
197864	SEARCH - Initial Participant Survey - Incident	Form	Modified	Initial Participant Survey - Incident Case Young Adult Version (screen shots)
197864	SEARCH - Initial Participant Survey - Incident	Form	Modified	Initial Participant Survey - Incident Case Child Version (Paper)
197864	SEARCH - Initial Participant Survey - Incident	Form	Modified	Initial Participant Survey - Incident Case Child Version (screen shots)

ICR Details

OMB Control No: 0920-0904	ICR Reference No: 201705-0920-019
Status: Historical Active	Previous ICR Reference No: 201405-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0904
Title: SEARCH for Diabetes in Youth Study
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/27/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/21/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved	10/31/2017
Responses	5,444	0	13,910
Time Burden (Hours)	2,016	0	4,248
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests OMB approval to continue collecting information in Phase 4 of a registry study known as SEARCH for Diabetes in Youth. OMB first approved this study in 2011 (OMB # 0920-0904, exp. 11/30/2014), and a revision was approved in 2014 (exp. 8/31/2017). OMB approval is requested for the final three years of the five year project. Phase 4 is built upon activities a multi-center initiated in 2000 through collaborative research project that involved six clinical sites and a data coordinating center, all funded through cooperative agreements. Phase 3 and 4 only included 5 clinical sites and a data coordinating center. A number of changes have been implemented and will continue during Phase 4. Respondents will continue to be youth < 20 years of age who have been diagnosed with diabetes or their parents. Information will support a case registry that can be used to estimate the incidence and prevalence of diabetes in youth in the U.S. IN Phase 3, CDC also funded a cohort component to this study. For Phase 4, CDC is no longer funding this component. The registry study will continue to collect information from participants who were initially diagnosed with diabetes in 2016 to complete an in-person study examination.

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Authorizing Statute(s): US Code: 42 USC 301 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 88685	12/08/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 32702	07/17/2017
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Peds QL Diabetes Module
SEARCH - Initial Participant Survey - Incident	n/a, n/a, n/a, n/a	Initial Participant Survey - Incident Case Child Version (screen shots) ,   Initial Participant Survey - Incident Case Child Version (Paper) ,   Initial Participant Survey - Incident Case Young Adult Version (screen shots) ,   Initial Participant Survey - Incident Case Young Adult version (paper)
SEARCH CES-Depression
SEARCH Diabetes Eating Problem Survey (DEPS-R)
SEARCH Diabetes Related Family Conflict Survey
SEARCH Food Frequency Questionnaire
SEARCH Health Questionnaire (Parent_Feb 2014) Cohort Study
SEARCH Health Questionnaire (Youth )
SEARCH Initial Participant Survey - Prevalence	n/a, n/a	Initial Participant Survey - Adult Prevalent Case ,   Initial Participant Survey - Child Prevalent Case
SEARCH Low Blood Surgar Survey
SEARCH Medication Inventory (Incident Case)	n/a	Medications Inventory
SEARCH Michigan Neuropathy Screening Instrument (MNSI)
SEARCH Pathology Notificaiton (Retinal Photo)
SEARCH PedsQL
SEARCH Physical Examination	n/a	Physical Examination Form
SEARCH Quality of Care Survey (Feb 2014)
SEARCH Specimen Collection Form	n/a	Specimen Collection Form
SEARCH Supplemental Questionnaire
SEARCH Tanner Stage

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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	5,444	13,910	0	1,474	-9,940	0
Annual Time Burden (Hours)	2,016	4,248	0	-670	-1,562	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: The SEARCH for Diabetes in Youth Study was initially approved with 4,248 annualized burden hours. In this Revision, we request approval for 1,879 annualized burden hours (a net reduction of 2,369 annualized burden hours).

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Annual Cost to Federal Government: $2,502,626

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 07/21/2017

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