Information Collection for Evaluation of Education, Communication, and Training Activities for Mobile Populations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Evaluation of an Education Intervention for Immigration Applicants with B1 or B2 Tuberculosis Classificati	Form	New	Available
Form 0920-0932 Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives	Form and Instruction	New	Repair queued
Attachment G Sample Screener.doc	Supplementary Document	Uploaded 2018-03-21	Available
Attachment F2 Sample Post-Test.doc	Supplementary Document	Uploaded 2018-03-21	Available
Attachment F1 Sample Pre-Test.doc	Supplementary Document	Uploaded 2018-03-21	Available
Attachment E Sample Survey.doc	Supplementary Document	Uploaded 2018-03-21	Available
Attachment D Sample Interview Guide.docx	Supplementary Document	Uploaded 2018-03-21	Available
Attachment C Sample Focus Group Guide.docx	Supplementary Document	Uploaded 2018-03-21	Available
Attachment B 60 day Federal Register Notice.pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A7 42 CFR part 34.pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A6 Section 325 of the Public Health Service Act.pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A5 Section 212(a)(1)(A) of the Immigration and Nationality Ac....pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A4 42 CFR part 71.pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A3 42 CFR part 70.pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A2 Section 361 of the Public Health Service Act (42 USC 264).pdf	Supplementary Document	Uploaded 2018-03-21	Available
Attachment A1 Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2018-03-21	Available
Supporting Statement B 0932 Revision 09202017.docx	Supporting Statement B	Uploaded 2018-03-21	Available
Supporting Statement A 0932 Revision 03152018.docx	Supporting Statement A	Uploaded 2018-03-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
239665	Evaluation of an Education Intervention for Immigration Applicants with B1 or B2 Tuberculosis Classificati	Form	New
232627	Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives	Form and Instruction	New

ICR Details

OMB Control No: 0920-0932	ICR Reference No: 201803-0920-013
Status: Active	Previous ICR Reference No: 201503-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0932
Title: Information Collection for Evaluation of Education, Communication, and Training Activities for Mobile Populations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2018
	Date Received in OIRA: 04/10/2018
Terms of Clearance: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval. When incentives are used, a justification must be provided.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved	07/31/2018
Responses	52,500	0	112,500
Time Burden (Hours)	23,946	0	53,505
Cost Burden (Dollars)	673,386	0	0

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Abstract: This generic clearance allows NCEZID to quickly collect information about the knowledge, attitudes, and behaviors from key audiences (such as refugees, immigrants, migrants, international travelers, travel industry partners, healthcare providers, non-profit agencies, customs brokers and forwarders, schools, state and local health departments) to help improve and inform education, communication, and training activities. This revision reduces the number of respondents and burden hours due to a reduction in estimated collections.

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Authorizing Statute(s): US Code: 42 USC 264 Name of Law: Public Health Service Act
   US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 42 USC part 70-71 Name of Law: Interstate and Foreign Quarantine
  

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:
	82 FR 5013	10/30/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 14856	04/06/2018
Did the Agency receive public comments on this ICR? Yes

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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
Evaluation of an Education Intervention for Immigration Applicants with B1 or B2 Tuberculosis Classificati	none, none, none, none, none, none, none, none, none, none, none, none	B1 Pretest ,   B1 Pretest - Spanish ,   B1 Post-test ,   B1 Post-test - Spanish ,   B2 Pretest ,   B2 Pretest - Spanish ,   B2 Post-test ,   B2 Post-test - Spanish ,   B1 Screener ,   B1 Screener - Spanish ,   B2 Screener ,   B2 Screener
Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives	0920-0932, 0920-0932, 0920-0932, 0920-0932	Viajo sin Zika Online Focus Group Screener - English ,   Viajo sin Zika Online Focus Group Screener - Spanish ,   Viajo sin Zika Online Focus Group Moderator Guide - English ,   Viajo sin Zika Online Focus Group Moderator Guide - Spanish

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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	52,500	112,500	0	-60,000	0	0
Annual Time Burden (Hours)	23,946	53,505	0	-29,559	0	0
Annual Cost Burden (Dollars)	673,386	0	0	673,386	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden as been reduced due to a reduction in the number of estimated collections from 10 to 5 per year, and reduction in the number of pre- and post-test responses requested.

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Annual Cost to Federal Government: $1,488,155

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.     No

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.     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: 04/10/2018

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