Att H_FY16 (Q4) Burden Memo

Attachment H. Burden Memo

CDC DOCUMENTATION FOR THE GENERIC CLEARANCE

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

GenIC No.:	0920-1036
CASPER Title:	Community Assessment for Public Health Emergency Response (CASPER) addressing the California Drought – Mariposa County, 2016
Requesting entity (e.g., jurisdiction)	Mariposa County Health Department, California Department of Public Health
Purpose of Investigation: (Use as much space as necessary)	California is in its sixth year of the most severe drought in its recorded history. Drought can have a substantial impact on the economy, the environment, and the affected communities, leading to both direct and indirect public health consequences. In Mariposa County, the drought has had a severe impact on the forests, resulting in thousands of acres of dying or dead trees. The response effort is ongoing. The Mariposa County Health Department and the California Department of Public Health (CDPH) is conducting a CASPER to assess the continued effects of the drought on the community. The results generated from this survey will be collected and analyzed to enhance drought-related response efforts. The CASPER will assess sources, quality, quantity, and ease of access to water before and during drought; communication practices and preferences; household knowledge, attitudes, and beliefs about drought and its mitigation; perception of the impact of drought on physical and mental health; financial impact of drought; and prevalence of behaviors that can make households more at-risk for drought-related health effects (for example, not washing hands because of water scarcity). CDC/HSB will provide technical assistance with preparing for the CASPER (e.g., questionnaire development), a 3-hour just-in-time training for CASPER teams, and data collection, entry, analysis, and reporting
Duration of Data Collection
Date Began:	October 25, 2016
Date Ended:	October 27, 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: Drought Community Assessment for Public Health Emergency Response – 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 will be used. In the first stage of selection, 30 clusters (i.e., census blocks) within each sampling frame will be 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 will apply 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):	189
Total No. Sampled or Eligible to Respond (B):	406
Response Rate (A/B):	46.6%

CASPER Referral Form

Title: CASPER Referral Form

Response Rate (if applicable)

Total No. Responded (A):	3
Total No. Sampled or Eligible to Respond (B):	406
Response Rate (A/B):	0.1%

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	189	1	30	5,670
CASPER Referral Form	Community member	3	1	5	15
TOTAL					5,685

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.