Assessment of the Cancer Survivorship Demonstration Project

ICR 201811-0920-001

OMB: 0920-1250

Federal Form Document

Forms and Documents
Document
Name
Status
Form
New
Form
New
Supplementary Document
2018-11-01
Supplementary Document
2018-11-01
Supplementary Document
2018-11-01
Supplementary Document
2018-11-01
Supplementary Document
2018-11-01
Supporting Statement B
2018-11-01
Supporting Statement A
2019-01-31
IC Document Collections
ICR Details
0920-1250 201811-0920-001
Active
HHS/CDC 0920-18AG
Assessment of the Cancer Survivorship Demonstration Project
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 02/04/2019
Retrieve Notice of Action (NOA) 11/20/2018
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved
56 0 0
28 0 0
721 0 0

This Information collection aims to assess six Division of Cancer Prevention and Control National Comprehensive Cancer Control Program DP15-1501-funded grantees' efforts. The assessment will determine their ability to implement evidence-based and promising strategies to increase knowledge of cancer survivor needs, increase utilization of surveillance data to inform program planning by providers and coalition members, and enhance partnerships to facilitate and broaden program reach. Information will be collected from DP15-1501 grantee staff and partners in two waves via Web-based surveys and semistructured telephone interviews.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  82 FR 52301 11/13/2017
83 FR 58570 11/20/2018
No

3
IC Title Form No. Form Name
Web-based Grantee Survey none, none Grantee Survey ,   Grantee Survey - screenshots
Web-based Partner Survey none, none Partner Survey ,   Partner Survey - screenshots
Telephone Interview

  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 56 0 0 56 0 0
Annual Time Burden (Hours) 28 0 0 28 0 0
Annual Cost Burden (Dollars) 721 0 0 721 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.

$54,360
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.
11/20/2018


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