“Promoting Adolescent Health through School-Based HIV/STD Prevention Reporting Templates”
Supporting Statement Part B
November 21, 2019
Supported by:
Division of Adolescent and School Health
Centers for Disease Control and Prevention
John Canfield, M.Ed. CHES
CDC/DDID/NCHHSTP, Health Education Specialist
(404) 718-8333
Table of Contents
A. 1 Circumstances Making the Collection of Information Necessary
A. 2 Purpose and Use of Information Collection
A. 3 Use of Improved Information Technology and Burden Reduction
A. 4 Efforts to Identify and Use of Similar Information
A. 5 Impact of Small Businesses or Other Small Entities
A. 6 Consequences of Collecting the Information Less Frequently
A. 7 Special Circumstances Relating to the Guidelines of 5 CFR 1320.5
A. 8 Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency
A. 9 Explanation of Any Payment or Gift to Respondents
A. 10 Assurance of Confidentiality Provided to Respondents
A. 11 Justification for Sensitive Questions
A. 12 Estimates of Annualized Burden Hours and Costs
A. 13 Estimates of Other Annual Cost Burden to Respondents or Record Keepers
A. 14 Annualized Cost to Federal Government
A. 15 Explanation for Program Changes or Adjustments
A. 16 Plans for Tabulation and Publication and Project Time Schedule
A. 17 Reason(s) Display of OMB Expiration Date is Inappropriate
A. 18 Exceptions to Certification for Paperwork Reduction Act Submissions
B.1 Respondent Universe and Sampling Methods 4
B.2 Procedures for the Collection of Information 5
B.3 Methods to Maximize Response Rates and Deal with No Response 6
B.4 Tests of Procedures or Methods to be Undertaken 7
B.5 Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data 7
List of Attachments
Attachment Number |
Document Description |
1 |
Public Health Service Act Legislation |
2 |
60 Day FRN |
3 |
Component 1 Reporting Template |
4 |
Component 2 Reporting Template |
5 |
Component 1 Required Programmatic Activities Work Plan |
6 |
Component 2 Required Programmatic Activities Work Plan |
7 |
Component 2 Professional Development Work Plan |
Section B: Collections of Information Employing Statistical Methods
The respondent universe for Component 1 reporting template and work plan consists of the PS18-1807 Program Managers for each funded agency. Eighty (80) sites will be completing the Component 1 reporting template and work plan. The respondent universe for Component 2 reporting template and work plans (required programmatic activities work plan and professional development work plan) consists of the PS18-1807 Program Manager for each funded agency. Twenty-five (25) sites will be completing the Component 2 reporting template and work plans (required programmatic activities work plan and professional development work plan). Data collection will be a census of all funded agencies.
This data collection is required every six months for the reporting templates by the Notice of Funding Opportunity (NOFO) and the Notice of Award (NOA) letter. Failure to complete the biannual report could result in a loss of future funding. Recipients will be reminded of the reporting requirements by their DASH Program Consultant via monthly calls and the DASH website. This data collection is required every twelve months for the work plans (required programmatic activities work plan and professional development work plan) by the Notice of Funding Opportunity (NOFO) and the Notice of Award (NOA) letter. Failure to complete the annual work plans (required programmatic activities work plan and professional development work plan) could result in a loss of future funding. Recipients will be reminded of the reporting requirements by their DASH Program Consultant via monthly calls and the DASH website.
The reporting templates and work plans (required programmatic activities work plan and professional development work plan) were developed with the extensive input of expert consultants internal to CDC. The reporting templates and work plans (required programmatic activities work plan and professional development work plan) were created around the required activities of the Notice of Funding Opportunity.
Individuals consulted on template design:
Elizabeth
Haller, BA, M.Ed.
CDC/DDID/NCHHSTP/DASH
Health Education Specialist
Atlanta, GA 30329
404-718-8268 (phone)
Malaika Washington, MSPH
CDC/DDID/NCHHSTP/DASH
Health Education Specialist
Atlanta, GA 30329
404-718-8262 (phone)
Lisa Barrios, DrPh
CDC/DDID/NCHHSTP/DASH
Branch Chief
Atlanta, GA 30329
404-718-8180 (phone)
The individuals overseeing data collection and directing data analysis are:
John Canfield, M.Ed. CHES
CDC/DDID/NCHHSTP/DASH
Health Education Specialist
Atlanta, GA 30329
404-718-8333 (phone)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Bleechington |
| File Modified | 0000-00-00 |
| File Created | 2021-01-13 |