Barriers and Facilitators to Expanding the NHBS to Conduct HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	New	Available
Eligible and consenting participants - NHBS-Trans Interview	Form and Instruction	New	Available
18 years old - Eligibility Screener	Form and Instruction	New	Available
Att 14_NHBS-Trans Interview Crosswalk.xlsx	Supplementary Document	Uploaded 2019-02-12	Available
Att 13_PIA Form NHBS-Trans.pdf	Supplementary Document	Uploaded 2019-02-12	Available
Att 11_Model Consent for Survey Activities.docx	Supplementary Document	Uploaded 2019-02-12	Available
Att 10_Agreement to abide by restrictions.docx	Supplementary Document	Uploaded 2019-02-12	Available
Att 9_Assurance of Confidentiality.pdf	Supplementary Document	Uploaded 2019-02-12	Available
Att 8_Emory University Report NHBS-Trans Recommendations.docx	Supplementary Document	Uploaded 2019-02-12	Available
0920-18AAE_SSB_04232019_clean.docx	Supporting Statement B	Uploaded 2019-04-24	Available
0920-18AAE_SSA_04232019_clean.docx	Supporting Statement A	Uploaded 2019-04-24	Available
Att 4_Model Recruiter Talking Points.docx	Supplementary Document	Uploaded 2019-02-12	Available
Att 3_Auth to Operate for DCC.pdf	Supplementary Document	Uploaded 2019-02-12	Available
Att 2_60 Day FRN.pdf	Supplementary Document	Uploaded 2019-02-11	Available
Att 1_Sect 301 PHSA.PDF	Supplementary Document	Uploaded 2019-02-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234908	Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	New
234907	Eligible and consenting participants - NHBS-Trans Interview	Form and Instruction	New
234906	18 years old - Eligibility Screener	Form and Instruction	New

ICR Details

OMB Control No: 0920-1262	ICR Reference No: 201902-0920-007
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-18AAE
Title: Barriers and Facilitators to Expanding the NHBS to Conduct HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/24/2019
	Date Received in OIRA: 02/15/2019
Terms of Clearance: OMB is approving this pilot study for a period of three years during which time CDC will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action. Should CDC seek to revise or change the methodology, incentives structure, questions, or sampling design at any or all of the participating sites, CDC will work with their desk officer to submit a nonsubstantive change request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	36 Months From Approved
Responses	2,790	0	0
Time Burden (Hours)	713	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: National HIV Behavioral Surveillance System among Transgender Women (NHBS-Trans) is a formative needs assessment regarding HIV risk behaviors, gaps and barriers to services, and other experiences of transgender women within racial and ethnic minority populations. This project seeks to improve our understanding of how to best measure HIV risk behaviors, gaps and barriers to services, and other experiences of transgender women by field-testing interviews and rapid HIV testing among 1,800 minority TG women living in 9 U.S. cities with high burden of HIV.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. 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 24478	05/29/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 2524	02/07/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Peer Recruiters - Recruiter Debriefing Form	NA, NA	Reruiter Defriefing Form - English ,   Recruiter Debriefing Form - Spanish
Transgender Women > 18 years old - Eligibility Screener	NA, NA	Eligibility Screener - English ,   Eligibility Screener - Spanish
Eligible and consenting participants - NHBS-Trans Interview	NA, NA	NHBS-Trans Interview - English ,   NHBS - Trans Interview - Spanish

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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	2,790	0	0	2,790	0	0
Annual Time Burden (Hours)	713	0	0	713	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: Submission of 0920-18AAE is a New ICR.

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Annual Cost to Federal Government: $2,275,529

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.     No

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: 02/15/2019

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