Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-18ANU Specimen Lab Form	Form and Instruction	New	Available
Form 0920-18ANU Spanish Vector Control Questionnaire	Form and Instruction	New	Available
Form 0920-18ANU Vector Control Questionnaire	Form and Instruction	New	Available
Form 0920-18ANU Year Two Combined Questionnaire	Form and Instruction	New	Available
Form 0920-18ANU Spanish KAP Younger Child	Form and Instruction	New	Available
Form 0920-18ANU Spanish KAP Older Child	Form and Instruction	New	Available
Form 0920-18ANU Spanish KAP Adult	Form and Instruction	New	Available
Form 0920-18ANU KAP Younger Child	Form and Instruction	New	Available
Form 0920-18ANU KAP Older Child	Form and Instruction	New	Available
Form 0920-18ANU KAP Adult	Form and Instruction	New	Available
Form 0920-18ANU Individual Questionnaire Spanish	Form and Instruction	New	Available
Form 0920-18ANU Individual Questionnaire	Form and Instruction	New	Available
Form 0920-18ANU Household Representative Questionnaire	Form and Instruction	New	Available
11. PIA_COPA.pdf	Supplementary Document	Uploaded 2018-12-20	Available
10. COPA Flyer.pdf	Supplementary Document	Uploaded 2018-12-20	Available
9. IRB Approval Letter.pdf	Supplementary Document	Uploaded 2018-12-20	Repair queued
3. Consent Form - Spanish.docx	Supplementary Document	Uploaded 2018-12-20	Available
3. Consent Form - English.docx	Supplementary Document	Uploaded 2018-12-20	Available
2. 60-Day FRN.pdf	Supplementary Document	Uploaded 2018-12-20	Available
1. Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2018-12-20	Available
SSB COPA NEW_after OMB review_3-21-2019_GPB_clean.docx	Supporting Statement B	Uploaded 2019-03-26	Available
SSA COPA NEW final_edits after OMB_3-21-2019-GPB_clean.docx	Supporting Statement A	Uploaded 2019-03-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234597	Specimen Collection	Form and Instruction	New	Specimen Lab Form
234596	Vector Control Intervention Questionnaire	Form and Instruction	New	Spanish Vector Control Questionnaire
234596	Vector Control Intervention Questionnaire	Form and Instruction	New	Vector Control Questionnaire
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	Year Two Combined Questionnaire
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	Spanish KAP Younger Child
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	Spanish KAP Older Child
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	Spanish KAP Adult
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	KAP Younger Child
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	KAP Older Child
234595	Knowledge, Attitudes, and Practices Individual Questionnaire	Form and Instruction	New	KAP Adult
234594	Individual Questionnaire	Form and Instruction	New	Individual Questionnaire Spanish
234594	Individual Questionnaire	Form and Instruction	New	Individual Questionnaire
234590	Household Representative Questionnaire	Form and Instruction	New	Household Representative Questionnaire

ICR Details

OMB Control No: 0920-1254	ICR Reference No: 201812-0920-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-18ANU
Title: Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/29/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/07/2019
Terms of Clearance: OMB is approving this information collection request for a period of three years during which time CDC will request approval to extend or revise the collection if CDC seeks to continue the information collection activity beyond the period approved under this action.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved
Responses	16,120	0	0
Time Burden (Hours)	3,471	0	0
Cost Burden (Dollars)	25,166	0	0

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Abstract: The purpose of this project is to establish longitudinal follow-up of a community cohort and evaluate the impact of vector control interventions in 14 clusters in southern Puerto Rico. The investigators have prior experience working in these communities; however, there is minimal available information regarding the prevalence or incidence of infection with tropical arboviruses, density of Ae. aegypti mosquitoes, or cluster members’ knowledge, attitudes, and practices regarding behaviors intended to avoid mosquitoes. Such information will be needed to inform decision-making regarding the location, design, and content of interventions to be implemented and evaluated to reduce the burden of these pathogens.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

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:
	83 FR 34586	07/20/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 66267	12/26/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Household Representative Questionnaire	0920-18ANU	Household Representative Questionnaire
Individual Questionnaire	0920-18ANU, 0920-18ANU	Individual Questionnaire ,   Individual Questionnaire Spanish
Knowledge, Attitudes, and Practices Individual Questionnaire	0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU	KAP Adult ,   KAP Older Child ,   KAP Younger Child ,   Spanish KAP Adult ,   Spanish KAP Older Child ,   Spanish KAP Younger Child ,   Year Two Combined Questionnaire
Specimen Collection	0920-18ANU	Specimen Lab Form
Vector Control Intervention Questionnaire	0920-18ANU, 0920-18ANU	Vector Control Questionnaire ,   Spanish Vector Control Questionnaire

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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	16,120	0	0	16,120	0	0
Annual Time Burden (Hours)	3,471	0	0	3,471	0	0
Annual Cost Burden (Dollars)	25,166	0	0	25,166	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new ICR

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Annual Cost to Federal Government: $1,126,143

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: 01/07/2019

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