genIC Approval Request

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 0923-0047)
TITLE OF INFORMATION COLLECTION: CDC National Center for Environmental
Health and CDC National Center for Emerging, Zoonotic, and Infectious Diseases Focus Groups
for Effective Risk Communication for Water-Related Emergencies and Disease Outbreaks
PURPOSE: The CDC National Center for Environmental Health together with the CDC National
Center for Emerging Zoonotic and Infectious Diseases is conducting a study to gather information
regarding COVID-19 issues and concerns, and how they might also impact how communities receive
information during a water-related emergency. A water-related emergency can be any emergency that
causes drinking water to become unsafe to drink. Examples of harmful water contamination include algal
blooms, floods, or chemical contamination. The current COVID-19 pandemic has raised new questions
regarding how risk communication messages for water-related emergencies may be impacted. Our
company, Powell Strategies, is supporting this effort by conducting focus groups with community
members who have experienced water-related public health emergencies. The information gathered from
the focus groups and study will be used to help public health staff improve how they communicate with
community members.

DESCRIPTION OF RESPONDENTS: The independent contractor, Powell Strategies, will
conduct nine, 90-minute long virtual focus groups (3 each in three U.S. cities) among U.S. adults
who have experienced a diverse range of water emergencies to test existing health
communication materials during a water emergency, and understand communication preferences.
Each focus group will include approximately 10 participants for a total of 90 participants.

TYPE OF COLLECTION: (Check one)
[] Customer Comment Card/Complaint Form
[] Usability Testing (e.g., Website or Software)
[x] Focus Group

[] Customer Satisfaction Survey
[] Small Discussion Group
[] Other: __________________

CERTIFICATION:
I certify the following to be true:
1. The collection is voluntary.
2. The collection is low burden for respondents and low-cost for the Federal Government.
3. The collection is non-controversial and does not raise issues of concern to other federal
agencies.
4. The results are not intended to be disseminated to the public.
5. Information gathered will not be used for the purpose of substantially informing influential
policy decisions.
6. The collection is targeted to the solicitation of opinions from respondents who have
experience with the program or may have experience with the program in the future.
Name: Heather Bair-Brake

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X

Digitally signed by
Heather D.
Heather D. Bairbrake -S7
2020.11.09
Bairbrake -S7 Date:
12:04:44 -05'00'

Heather Brake

Associate Director for Communication Sciences

To assist review, please provide answers to the following question:

Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [x] Yes [] No
PII are used only for recruitment purposes.
2. If Yes, is the information that will be collected included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ x ] No
3. If Applicable, has a System or Records Notice been published? [] Yes [] No
A SORN is not applicable. Focus group results will not be retrieved by PII.
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? [x] Yes [] No

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BURDEN HOURS
Estimated Annualized Burden Hours
Type of
Respondents
Community
Members

Form Name
Screening Survey
Focus Group
Discussion Guide

225

No. of
Responses per
Respondent
1

Avg. Burden
per Response
(in hrs.)
10/60

90

1

90/60

No. of
Respondents

Total

Total Burden
(in hrs.)
38
135
173

FEDERAL COST: The estimated annual cost to the Federal government is $351,500, based on 20
hours of FTE time ($1,500) and the cost of the focus group contract ($350,000).
If you are conducting a focus group, survey, or plan to employ statistical methods, please provide
answers to the following questions:
The selection of your targeted respondents
1. Do you have a customer list or something similar that defines the universe of potential respondents
and do you have a sampling plan for selecting from this universe?
[ x] Yes
[] No
If the answer is yes, please provide a description of both below (or attach the sampling plan). If the
answer is no, please provide a description of how you plan to identify your potential group of
respondents and how you will select them?
The contractor, Powell Strategies, will recruit a sample of U.S. adults who have experienced a diverse
range of water emergencies to participate in nine virtual focus groups of at least 10 individuals per
group. Recruitment will occur in the following three communities: Wilmington, NC, Salem, OR, and
Newark, NJ. There will be three focus groups in each city for a total of nine focus groups. The
contractor will use screening and recruitment materials developed by the Centers for Disease Control
and Prevention (CDC) and follow CDC guidance. A copy of the instruments, including the screening
instrument, recruitment flyer, and focus group discussion guide are included as attachments.
Conducting virtual focus groups will minimize COVID-19 exposures to assure the safety of the focus
group participants and to the staff conducting the virtual meetings for CDC.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[] Web-based or other forms of Social Media
[] Telephone
[] In-person
[] Mail
[x] Other, explain: Participants will be asked to engage in a virtual focus group via
videoconferencing software (e.g. Zoom, GoToMeeting, etc.)
2. Will interviewers or facilitators be used? [x] Yes [] No

Please also attach any relevant documents pertaining to this project, such as protocols,
consent forms, surveys or other data collection instruments, technical assist letters,
nondisclosure agreements, or IRB approval.
List of Attachments:
AttA_Rcrtmnt_Protocol_Screening_Instrmnt
AttB_Rcrtmnt_Flyer
AttC_Participant_Info
AttD_FocusGroup_Guide
AttE_TstMsg1_Making_Water_Safe_Webpage
AttF_TstMsg2_Cleaning_Sntzng_Bleach_Webpage
AttG_TstMsg3_Boil_Water_Facts
AttH_PRAWorksheet_2.1
AttI_PRAWorksheet_2.2
AttJ_STARS_Determination

Instructions for completing Request for Approval under the “Generic
Clearance for the Collection of Routine Customer Feedback”
TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the
subject of the request. (e.g. Comment card for soliciting feedback on xxxx)
PURPOSE: Provide a brief description of the purpose of this collection and how it will be used.
If this is part of a larger study or effort, please include this in your explanation.

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DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or
groups for this collection of information. These groups must have experience with the program.
TYPE OF COLLECTION: Check one box. If you are requesting approval of other
instruments under the generic, you must complete a form for each instrument.
CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the
collection will be returned as improperly submitted or it will be disapproved.
Personally Identifiable Information: Provide answers to the questions.
Gifts or Payments: If you answer yes to the question, please describe the incentive and provide
a justification for the amount.
BURDEN HOURS:
Category of Respondents: Identify who you expect the respondents to be in terms of the
following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal
governments; or (4) Federal Government. Only one type of respondent can be selected.
No. of Respondents: Provide an estimate of the Number of respondents.
Participation Time: Provide an estimate of the amount of time required for a respondent to
participate (e.g. fill out a survey or participate in a focus group)
Burden: Provide the Annual burden hours: Multiply the Number of responses and the
participation time and divide by 60.
FEDERAL COST: Provide an estimate of the annual cost to the Federal government.
If you are conducting a focus group, survey, or plan to employ statistical methods, please
provide answers to the following questions:
The selection of your targeted respondents. Please provide a description of how you plan to
identify your potential group of respondents and how you will select them. If the answer is yes,
to the first question, you may provide the sampling plan in an attachment.
Administration of the Instrument: Identify how the information will be collected. More than
one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or
facilitators (e.g., for focus groups) used.
Please make sure that all instruments, instructions, and scripts are submitted with the
request.

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