Evaluation of the DP18-1801 Healthy Schools Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Wave 2 - School Staff Key Informant Interview	Form and Instruction	New	Available
Wave 2 - School Staff Web Survey	Form and Instruction	New	Available
Wave 2 - LEA Staff Key Informant Interview	Form and Instruction	New	Available
Wave 2 - LEA Staff Web Survey	Form and Instruction	New	Available
Wave 2 - SEA Staff Key Informant Interview	Form and Instruction	New	Available
Wave 2 - SEA Staff Web Survey	Form and Instruction	New	Available
Wave 1 - School Staff Key Informant Interview	Form and Instruction	New	Available
Wave 1 - School Staff Web Survey	Form and Instruction	New	Available
Wave 1 - LEA Staff Key Informant Interview	Form and Instruction	New	Available
Wave 1 - LEA Staff Web Survey	Form and Instruction	New	Available
Wave 1 - SEA Staff Key Informant Interview	Form and Instruction	New	Available
Wave 1 - SEA Staff Web Survey	Form and Instruction	New	Available
1801 Evaluation_Supporting Statement Part B_6.8.2020 CLEAN.DOCX	Supporting Statement B	Uploaded 2020-06-11	Available
1801 Evaluation_Supporting Statement Part A_6.8.2020 CLEAN.DOCX	Supporting Statement A	Uploaded 2020-06-11	Available
Attachment L - School Survey Reminder Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment K - LEA Survey Reminder Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment J- SEA Survey Reminder Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment I - School Interview Scheduling Email 6.8.2020_CLEAN.DOCX	Supplementary Document	Uploaded 2020-06-11	Available
Attachment H - LEA Interview Scheduling Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment G - SEA Interview Scheduling Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment F - School Survey Responded First Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment E - LEA Survey Respondent First Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment D - SEA Survey Respondent First Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment C - School Initial Contact Approval Request Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment B - LEA Initial Contact Approval Request Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment A - SEA Initial Contact Approval Request Email.docx	Supplementary Document	Uploaded 2019-12-02	Available
Attachment 10 - ICF Institutional Review Board Approval Memorandum.pdf	Supplementary Document	Uploaded 2019-12-02	Available
Attachment 2a - 60-day Federal Register Notice Response to Comments.docx	Supplementary Document	Uploaded 2019-11-27	Available
Attachment 2 - 60-day Federal Register Notice.pdf	Supplementary Document	Uploaded 2019-11-27	Available
Attachment 1 - Authorizing Legislation.docx	Supplementary Document	Uploaded 2019-11-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238745	Wave 2 - School Staff Key Informant Interview	Form and Instruction	New
238744	Wave 2 - School Staff Web Survey	Form and Instruction	New
238743	Wave 2 - LEA Staff Key Informant Interview	Form and Instruction	New
238742	Wave 2 - LEA Staff Web Survey	Form and Instruction	New
238741	Wave 2 - SEA Staff Key Informant Interview	Form and Instruction	New
238740	Wave 2 - SEA Staff Web Survey	Form and Instruction	New
238739	Wave 1 - School Staff Key Informant Interview	Form and Instruction	New
238738	Wave 1 - School Staff Web Survey	Form and Instruction	New
238737	Wave 1 - LEA Staff Key Informant Interview	Form and Instruction	New
238736	Wave 1 - LEA Staff Web Survey	Form and Instruction	New
238733	Wave 1 - SEA Staff Key Informant Interview	Form and Instruction	New
238731	Wave 1 - SEA Staff Web Survey	Form and Instruction	New

ICR Details

OMB Control No: 0920-1302	ICR Reference No: 201910-0920-010
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-19BIW
Title: Evaluation of the DP18-1801 Healthy Schools Program
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: 06/23/2020
	Date Received in OIRA: 12/03/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2023	36 Months From Approved
Responses	636	0	0
Time Burden (Hours)	798	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this evaluation activity is to inform stakeholders about implementation and impact of the DP18-1801 program within SEAs, LEAs, and schools, and will be used to improve the quality of programming implemented to enhance nutrition, physical activity, and management of chronic health conditions in schools. The Centers for Disease Control and Prevention's (CDC) School Health Branch (SHB) will use the resulting data to (1) inform stakeholders about implementation and impact of the 1801 program within State Education Agencies (SEAs), Local Education Agencies (LEAs), and schools, and (2) improve the quality of programming implemented to enhance nutrition, physical activity, and management.

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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:
	84 FR 35863	07/25/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 62532	11/15/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
Wave 1 - LEA Staff Web Survey	NA	LEA Implementation Survey
Wave 1 - LEA Staff Key Informant Interview	NA	LEA Key Informant Interview Guide
Wave 1 - School Staff Web Survey	NA	School Staff Implementation Survewy
Wave 1 - School Staff Key Informant Interview	NA	School Staff Key Informant Interview Guide
Wave 2 - SEA Staff Key Informant Interview	NA	SEA Key Informant Interview Guide
Wave 2 - LEA Staff Key Informant Interview	NA	LEA Key Informant Interview Guide
Wave 2 - School Staff Web Survey	NA	School Staff Implementation Survey
Wave 2 - School Staff Key Informant Interview	NA	School Staff Key Informant Interview Guide
Wave 2 - SEA Staff Web Survey	NA	SEA Implementation Survey
Wave 2 - LEA Staff Web Survey	NA	LEA Implementation Survey
Wave 1 - SEA Staff Web Survey	NA	SEA Implementation Survey
Wave 1 - SEA Staff Key Informant Interview	NA	SEA Key Informant Interview Guide

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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	636	0	0	636	0	0
Annual Time Burden (Hours)	798	0	0	798	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: The 0920-19BIW - Evaluation of the DP18-1801 Healthy Schools Program package is being submitted by CDC as a New ICR.

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Annual Cost to Federal Government: $272,262

Does this IC contain surveys, censuses, or employ statistical methods? No

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? No

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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: 12/03/2019

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