Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

ICR 201804-0920-005

OMB: 0920-0612

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Unchanged
Justification for No Material/Nonsubstantive Change
2018-04-11
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supplementary Document
2016-11-02
Supporting Statement B
2016-11-02
Supporting Statement A
2016-11-02
ICR Details
0920-0612 201804-0920-005
Historical Active 201611-0920-003
HHS/CDC 0920-0612 (18YZ)
Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/03/2018
Retrieve Notice of Action (NOA) 04/12/2018
  Inventory as of this Action Requested Previously Approved
12/31/2018 12/31/2018 12/31/2018
63 0 63
1,344 0 1,344
0 0 0

CDC request OMB approval for a non-Substantive change to the approved WISEWOMAN information collection. The request is to modify the WISEWOMAN program's reporting system, used to both screen and monitor participants, as well as to evaluate and improve program efficacy. The proposed change is to the minimum data elements (MDE) part of system to improve data accuracy and analytical utility, as well as to streamline the questionnaire flow for respondents.

PL: Pub.L. 101 - 354 300 Name of Law: The Breast and Cervical Cancer Mortality Prevention Act of 1990
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  81 FR 48806 07/26/2016
81 FR 78158 11/07/2016
No

  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 63 63 0 0 0 0
Annual Time Burden (Hours) 1,344 1,344 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$370,250
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/12/2018


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