FY16Q3 Burden memo

Attachment H_Burden Memo_final.docx

California Drought - Mariposa County, 2016 (Quarter 4)

FY16Q3 Burden memo

OMB: 0920-1036

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Attachment H. Burden Memo



CDC DOCUMENTATION FOR THE GENERIC CLEARANCE

OF COMMUNITY ASSESSMENT FOR PUBLIC HEALTH EMERGENCY RESPONSE (CASPER) DATA COLLECTIONS (0920-1036)

Shape1


GenIC No.:

0920-1036

CASPER Title:

Undetermined health effects among persons affected by flooding – West Virginia, 2016

Requesting entity (e.g., jurisdiction)

West Virginia Bureau for Public Health

Purpose of Investigation: (Use as much space as necessary)


On June 23, 2016, a band of severe thunderstorms and heavy rain throughout the state of West Virginia overwhelmed numerous rivers and streams, causing extensive flooding throughout the state. Currently, the affected population’s access to routine health care and public health systems, information sources, water sources, and health impacts due to flooding and flood damage is unclear. There is an urgent need for information on the aforementioned topics to focus ongoing public health response efforts in the affected communities. Data from the two CASPERs will be used to inform the continued response activities including access to health care; communication and messaging regarding water sources, cleanup activities, and other response-related activities; and allocation of public health resources.

Duration of Data Collection


Date Began:

August 1, 2016

Date Ended:

August 2, 2016

Lead Investigator


Name:

Amy Helene Schnall, MPH

CIO/Division/Branch:

NCEH/DEHHE/HSB

E-mail Address:

[email protected]

Telephone No.:

770.488.3422

Mail Stop:

F60



Complete the following for each instrument used during the investigation.


CASPER Questionnaire


Title: Undetermined health effects of persons affected by flooding – West Virginia, 2016



Data Collection Methods (i.e., was the standard CASPER methodology of probability-based, two stage 30x7 cluster sampling methodology used or was an alternative approved methodology used? Please describe.): The standard CASPER methodology of probability-based, two stage 30x7 cluster sampling methodology was used. In the first stage of selection, 30 clusters (i.e., census blocks) within each sampling frame were selected with their probability for being chosen proportional to the estimated number of households in each cluster. In the second stage, each trained, two-person interview team applied systematic random sampling to select seven households for the purpose of conducting interviews in each of the selected clusters.


Data Collection Mode (i.e., was questionnaire data collected via paper form or electronic form? Please describe.):

The questionnaire data was collected via paper form by field interview teams.

Response Rate (if applicable)

Total No. Responded (A):

392

Total No. Sampled or Eligible to Respond (B):

814

Response Rate (A/B):

48.2%




CASPER Referral Form


Title: CASPER Referral Form


Response Rate (if applicable)

Total No. Responded (A):

9

Total No. Sampled or Eligible to Respond (B):

814

Response Rate (A/B):

1.1%


Complete the following burden table. Each data collection instrument should be included as a separate row.


Burden Table

Data Collection Instrument Name

Type of Respondent

No. Respondents (A)

No. Responses per Respondent (B)

Burden per Response in Minutes (C)

Total Burden

(in minutes;

A x B x C)

CASPER Questionnaire

Community member

392

1

30

11,760

CASPER Referral Form

Community member

9

1

5

45








Return completed form and a blank copy of each final data collection instrument within 5 business days of data collection completion to the ICRL (e-mail: [email protected]; MS F-61). If data was collected electronically, please also submit screen shots.


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