National Diabetes Prevention Program Introductory Session Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-19BOI Introductory Session Landscape Assessment	Form and Instruction	New	Available
19BOI Att 2h Intro Session Data Coll Reminder Email Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2g Intro Session Data Coll Reminder Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2f Intro Session Recruit 3rd Reminder Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2e Intro Session Recruit 2nd Reminder Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2d Intro Session Recruit 1st Reminder Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2c Intro Session Data Coll Overvw Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2b Intro Session Eval Recruit Email Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 2a Prenotification Email Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1g Phase 1 Thank You Email Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1f Phase 1 Follow Up Ltr Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1e Phase 1 Follow Up Email 3 Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1d Phase 1 Follow Up Email 2 Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1c Phase 1 Follow Up Email 1 Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1b Phase 1 Intro Email Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 1a Prenotify Ltr for Landscape Ass Survey Final.docx	Supplementary Document	Uploaded 2020-02-11	Available
19BOI PIA Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Privacy Narrative Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 10 Published 60 day FRN Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 9 Authorizing Legislation Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 8 IRB Approval Evaluation Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI Att 7 IRB Approval Landscape Ass Final.pdf	Supplementary Document	Uploaded 2020-02-11	Available
19BOI SSB Final.docx	Supporting Statement B	Uploaded 2020-02-11	Available
19BOI SSA Final.docx	Supporting Statement A	Uploaded 2020-02-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
239911	Introductory Session Landscape Assessment	Form and Instruction	New

ICR Details

OMB Control No: 0920-1300	ICR Reference No: 202002-0920-004
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-19BOI
Title: National Diabetes Prevention Program Introductory Session Project
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 without change	Conclusion Date: 06/02/2020
	Date Received in OIRA: 02/25/2020
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	5,478	0	0
Time Burden (Hours)	1,572	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: This Federal Register notice requests public comment on a new data collection under the Paperwork Reduction Act. The purpose of this data collection is to: (1) determine the prevalence and types of introductory sessions being offered as a recruitment strategy to increase enrollment in the National Diabetes Prevention Program Lifestyle Change Program (National DPP LCP); and (2) to evaluate a behaviorally-focused introductory session known as Be Your Best Discovery Session compared with already occurring introductory sessions

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 46536	09/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 10700	02/25/2020
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Introductory Session Landscape Assessment	0920-19BOI , 0920-19BOI, 0920-19BOI, 0920-19BOI, 0920-19BOI	Introductory Session Landscape Assessment ,   Pre Session Survey ,   Post- Session Survey ,   BYB Discovery Session Implementation Fidelity Checklist ,   REGISTRATION AND ATTENDANCE TRACKING FORM

---

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	5,478	0	0	5,478	0	0
Annual Time Burden (Hours)	1,572	0	0	1,572	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 program is requesting approval for 1,572 hours.

---

Annual Cost to Federal Government: $527,710

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? No

---

Common Form ICR:  No

---

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: 02/25/2020

---