Information Collection on Soil-transmitted Helminth Infections in Alabama and Mississippi

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
UMMC Anthropometric Data	Form	New	Available
UMMC Questionnaire	Form	New	Available
UAB Questionnaire	Form	New	Available
Part of I. Hookworm Study FlyerFINAL.pdf	Supplementary Document	Uploaded 2019-10-07	Available
Attachment B_60-day FRN_04022019.pdf	Supplementary Document	Uploaded 2019-07-11	Available
SSA_STH in US_06242019_rev0711 (OMB)_AS 09232019_clean (1).docx	Supporting Statement A	Uploaded 2019-10-07	Available
Attachment I.UMMC_Recent MPP Flyer approved 5.21.2019 (002).pdf	Supplementary Document	Uploaded 2019-06-24	Available
Attachment H. UAB_Project Info for Stakeholders (002).pdf	Supplementary Document	Uploaded 2019-06-24	Available
Attachment G. CGH Non Engaged Determination.2017-017c-.pdf	Supplementary Document	Uploaded 2019-06-24	Available
Attachment F. IRB Approvals.pdf	Supplementary Document	Uploaded 2019-06-24	Available
Attachment A_PHSA.pdf	Supplementary Document	Uploaded 2019-06-24	Available
Supp Statement B_STH in US_06172019_clean.docx	Supporting Statement B	Uploaded 2019-06-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238016	Specimen collection - stool sample	Other-Specimen collection - stool	New
238015	Specimen collection - fingerprick	Other-Blood Specimen Collection	New
236770	Anthropometric measurements - Mississippi	Form	New	UMMC Anthropometric Data
236769	UMMC Questionnarie	Form	New	UMMC Questionnaire
236633	UAB Questionnaire	Form	New	UAB Questionnaire

ICR Details

OMB Control No: 0920-1271	ICR Reference No: 201906-0920-008
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-19ABV
Title: Information Collection on Soil-transmitted Helminth Infections in Alabama and Mississippi
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: 10/09/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/11/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2022	36 Months From Approved
Responses	5,148	0	0
Time Burden (Hours)	540	0	0
Cost Burden (Dollars)	3,904	0	0

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Abstract: This data collection is needed to determine if soil-transmitted helminth (STH) infections represent an unrecognized problem in communities in the southeastern United States and to understand risk factors associated with infection. Relatively few resources have been devoted to surveillance, prevention and treatment of STH infections in recent years and they are missed by routine information collection systems in the United States.

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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:
	84 FR 12612	04/02/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 32922	07/10/2019
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
Anthropometric measurements - Mississippi	none	UMMC Anthropometric Data
Specimen collection - fingerprick
Specimen collection - stool sample
UAB Questionnaire	none, none	UAB Questionnaire
UMMC Questionnarie	none	UMMC 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	5,148	0	0	5,148	0	0
Annual Time Burden (Hours)	540	0	0	540	0	0
Annual Cost Burden (Dollars)	3,904	0	0	3,904	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: $1,509,329

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: 07/11/2019

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