Privacy Impact Assessment

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Privacy Impact Assessment Form
v 1.21
Status

Form Number

0920-18PR

Question

07/16/18

Answer

1

OPDIV:

CDC\NIOSH\WTCHP

2

PIA Unique Identifier:

TBD

2a Name:

Form Date

The World Trade Center Health Program: Impact Assessment an
General Support System (GSS)
Major Application

3

The subject of this PIA is which of the following?

Minor Application (stand-alone)
Minor Application (child)
Electronic Information Collection
Unknown

3a

Identify the Enterprise Performance Lifecycle Phase
of the system.

Implementation
Yes

3b Is this a FISMA-Reportable system?

4

Does the system include a Website or online
application available to and for the use of the general
public?

5

Identify the operator.

6

Point of Contact (POC):

7

Is this a new or existing system?

8

Does the system have Security Authorization (SA)?

No
Yes
No
Agency
Contractor
POC Title

Security Steward

POC Name

Joe DuPont

POC Organization CDC/NIOSH/WTCHP
POC Email

[email protected]

POC Phone

304-285-5980
New
Existing
Yes
No

8b Planned Date of Security Authorization
Not Applicable

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8c

Briefly explain why security authorization is not
required

Not applicable

10

Describe in further detail any changes to the system
that have occurred since the last PIA.

Not applicable

11 Describe the purpose of the system.

The National Institute for Occupational Safety and Health
(NIOSH) with the help of a contract agency is proposing to
evaluate progress toward translational research funded
through the World Trade Center Health Program (WTCHP). As
part of a mixed-methods assessment of the program's research
investments, we plan to hold a series of focus groups with
different stakeholder groups to explore their perspectives on
translational research in the context of the WTCHP.
The results of the focus groups will be used to: (1) gather data
to help inform an evaluation of the WTCHP and development
of strategic planning recommendations; (2) complement
interviews to be conducted in another part of the qualitative
WTCHP evaluation; and (3) potentially inform selection of
interview participants based on an assessment of focus group
participant feedback across demographic characteristics.
Qualitative data (namely, participant responses to a structured
focus group discussion guide) will be audio-recorded,
transcribed, and de-identified before analysis in standard
qualitative analysis software. Questions will cover a series of
topics: the role of research in the WTCHP; participants'
interpretations of translational research; their views on the
research priorities set out by the WTCHP; research gaps they
recommend for future research; barriers to the use of scientific
research in the WTCHP; and their views on the WTCHP
research-to-care logic model.

Describe the type of information the system will
collect, maintain (store), or share. (Subsequent
12
questions will identify if this information is PII and ask At the conclusion of the focus group, participants will
complete an anonymous demographic paper-based survey
about the specific data elements.)
that asks for truncated year of birth, sex, race, WTCHP Role,
member type (if applicable), clinician specialty (if applicable)
and number of years involved in the WTCHP Program.

To recruit participants for the focus groups, NIOSH/WTCHP will
provide the contractor with names and email addresses of
potential participants to be contacted. These names and email
addresses will not be linked in any way (and cannot be linked
in any way) to participant responses in either the focus group
or on the demographic survey.

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This information collection request refers to the conduct of a
series of focus groups involving different stakeholders within
the WTCHP in order to perform an Impact Assessment and
Strategic Planning for Translational Research. The focus groups
will be conducted by telephone, or depending on scheduling
availability, in person. The focus groups will follow a structured
discussion guide and participants will respond to the questions
contained in the discussion guide.
At the conclusion of the focus group, participants will fill out a
brief paper-based survey for the researchers to report
aggregated descriptive statistics of the characteristics of focus
group participants (e.g., percent of male participants, average
age, etc.). The results of the demographic survey will be stored
in an Excel file that will be password protected and not linkable
to individuals' responses in the focus groups.
Provide an overview of the system and describe the
13 information it will collect, maintain (store), or share,
either permanently or temporarily.

To recruit participants for the focus groups, NIOSH/WTCHP will
provide the contractor with names and email addresses of
potential participants to be contacted from already existing
rosters; these data will not be collected as part of the focus
groups. Any names stated during the focus groups will be
deleted from the transcripts before analysis. The list of names
and emails will be stored temporarily and only as long as
necessary to complete recruitment and post-focus group
follow-up. All names/email addresses will be destroyed upon
completion of the assessment.
The contractor will temporarily collect, maintain, and store
gathered information. After collection and analysis of the data,
a final report and a copy of the raw data is turned over to
WTCHP. The contractor will permanently delete all gathered
information.
Data given to NIOSH will be stored and analyzed in a secure,
password-protected analysis software program, but it will not
be shared with anyone outside of NIOSH. Only aggregate
results will be reported.

14 Does the system collect, maintain, use or share PII?

Yes
No

REVIEWER QUESTIONS: The following section contains Reviewer Questions which are not to be filled out unless the user is an OPDIV
Senior Officer for Privacy.

Reviewer Questions
1

Are the questions on the PIA answered correctly, accurately, and completely?

Answer
Yes
No

Reviewer
Notes
2

Does the PIA appropriately communicate the purpose of PII in the system and is the purpose
justified by appropriate legal authorities?

Yes
No

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Reviewer Questions

Answer

Reviewer
Notes
3

Do system owners demonstrate appropriate understanding of the impact of the PII in the
system and provide sufficient oversight to employees and contractors?

Yes
No

Reviewer
Notes
4

Does the PIA appropriately describe the PII quality and integrity of the data?

Yes
No

Reviewer
Notes
5

Is this a candidate for PII minimization?

Yes
No

Reviewer
Notes
6

Does the PIA accurately identify data retention procedures and records retention schedules?

Yes
No

Reviewer
Notes
7

Are the individuals whose PII is in the system provided appropriate participation?

Yes
No

Reviewer
Notes
8

Does the PIA raise any concerns about the security of the PII?

Yes
No

Reviewer
Notes
9

Is applicability of the Privacy Act captured correctly and is a SORN published or does it need
to be?

Yes
No

Reviewer
Notes
10

Is the PII appropriately limited for use internally and with third parties?

Yes
No

Reviewer
Notes
11

Does the PIA demonstrate compliance with all Web privacy requirements?

Yes
No

Reviewer
Notes
12

Were any changes made to the system because of the completion of this PIA?

Yes
No

Reviewer
Notes

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General Comments

OPDIV Senior Official
for Privacy Signature

Jarell
Oshodi -S

Digitally signed by Jarell
HHS Senior
Oshodi -S
Agency Official
Date: 2018.11.06
for Privacy
12:35:03 -05'00'

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