Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0800 Focus Group Testing to Effectively Plan and Tailor a Young Women and Breast Cancer Communication Campaign	Form and Instruction	New	Available
0920-0800 PIA form - Focus group Testing - CAllen edits_3.pdf	Supplementary Document	Uploaded 2018-08-14	Available
Appendix E_Example Questions Discussion Guide_reinstatement.doc	Supplementary Document	Uploaded 2018-08-14	Available
Appendix D_Example Consent Form_2017 reinstatment.doc	Supplementary Document	Uploaded 2018-08-14	Available
Appendix C_Example Questions for Focus Group Screening_reinstatement v4.doc	Supplementary Document	Uploaded 2018-08-14	Available
Appendix B_60-day Federal Register Notice.pdf	Supplementary Document	Uploaded 2018-08-14	Available
Appendix A2_Public Health Service Act_Johannas Law.pdf	Supplementary Document	Uploaded 2018-08-14	Available
Appendix A1_Public Health Service Act.pdf	Supplementary Document	Uploaded 2018-08-14	Available
0920-0800 SS Part B_2017 reinstatement_for review.doc	Supporting Statement B	Uploaded 2018-08-14	Available
0920-0800 SS Part A_2017 reinstatement_for review_v4.doc	Supporting Statement A	Uploaded 2018-08-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
235525	Focus Group Testing to Effectively Plan and Tailor a Young Women and Breast Cancer Communication Campaign	Form and Instruction	New

ICR Details

OMB Control No: 0920-0800	ICR Reference No: 201808-0920-001
Status: Active	Previous ICR Reference No: 201408-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-08AJ
Title: Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/01/2018
	Date Received in OIRA: 08/31/2018
Terms of Clearance: Previous terms of clearance continue: This generic clearance for HHS/CDC Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns is approved under the following conditions: 1) HHS/CDC shall use the generic clearance to collect general public and health care professionals data (via focus groups) where the agency seeks to gather information for general service improvement, not for publication or for the purpose of informing significant policy or resource allocation decisions. 2) Focus groups should be of limited size and scope. 3) For individual focus groups, HHS/CDC shall submit a generic IC in ROCIS along with an abbreviated supporting statement in the template agreed to by OMB and HHS/CDC. This statement shall include all relevant information, including a statement of need, intended use of information, description of respondents, information collection procedures, expected response rate, justification for incentive, and estimated burden.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2021	36 Months From Approved
Responses	7,200	0	0
Time Burden (Hours)	5,040	0	0
Cost Burden (Dollars)	91,950	0	0

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Abstract: CDC is requesting a three-year reinstatement of the recently expired 0920-0800. Formative research will be conducted to assist in planning, developing, and/or tailoring cancer-related health messages and communication campaigns. Information is collected through focus groups involving the general public, health care professionals, or specific target audiences. No changes to the scope or methods.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   US Code: 42 USC 247b-17 Name of Law: Gynecologic Cancer Education and Awareness Act, Johanna's Law
  

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 58606	12/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 44631	08/31/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Focus Group Testing to Effectively Plan and Tailor a Young Women and Breast Cancer Communication Campaign	0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800, 0920-0800	Discussion Guide for Hispanic (family history) Eng ,   Discussion Guide for Hispanic (family history) Spa ,   Discussion Guide for Hispanic (no fam hist) Eng ,   Discussion Guide for Hispanic (no fam hist) Spa ,   Discussion Guide for AA (family history) ,   Discussion Guide for AA (no fam hist) ,   Discussion Guide for AIAN (family history) ,   Discussion Guide for AIAN (no fam hist) ,   Screening Instrument Hispanic Eng ,   Screening Instrument Hispanic Spa ,   Screening Instrument AA ,   Screening Instrument AIAN

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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	7,200	0	0	0	0	7,200
Annual Time Burden (Hours)	5,040	0	0	0	0	5,040
Annual Cost Burden (Dollars)	91,950	0	0	10,016	0	81,934

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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $491,600

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.     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: 08/31/2018

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