Availability, Use, and Public Health Impact of Emergency Supply Kits among Disaster-Affected Populations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Focus Group screener	Form and Instruction	New	Available
Focus group screener	Form and Instruction	New	Repair queued
Survey questionnaire - web-based	Form	New	Available
Questionnaire - web-based	Form	New	Repair queued
Survey questionnaire	Form	New	Available
Questionnaire - paper-based	Form	New	Repair queued
1 - Emergency Supply Kits_SSA_20210108.docx	Supporting Statement A	Uploaded 2021-02-08	Repair queued
P_Att7C_FocusGrp_TrckngSheet_20200924 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att7B_FocusGrp Inf Cnsnt_20201117_clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att7_FocusGrp Protocol_20210114 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att6_Survey Postcard Rmndr_20200924 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att5A_Survey Inf Cnsnt__WebBased_20200924 clean.pdf	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att5_Survey Inf Cnsnt_PaperBased_20200924 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att4_Survey Intro Lttr_20200924 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
P_Att3_Survey Non-Prob Panel Invtation_20200924 clean.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
AppndxC IRB Apprvl Memo.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
AppndxB 60D FRN.pdf	Supplementary Document	Uploaded 2021-01-27	Repair queued
AppndxA_AuthorizingLegislation.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
1 - Emergency Supply Kits_List Appndcs Attmnts_20210108.docx	Supplementary Document	Uploaded 2021-01-27	Repair queued
1 - Emergency Supply Kits_SSB_20210108.docx	Supporting Statement B	Uploaded 2021-01-27	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
245449	Focus group discussion guide	Other-Discussion guide	New
245448	Focus group screener	Form and Instruction	New	Focus Group screener
245448	Focus group screener	Form and Instruction	New
245447	Questionnaire - web-based	Form	New	Survey questionnaire - web-based
245447	Questionnaire - web-based	Form	New
245446	Questionnaire - paper-based	Form	New	Survey questionnaire
245446	Questionnaire - paper-based	Form	New

ICR Details

OMB Control No: 0920-1344	ICR Reference No: 202101-0920-016
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20QN
Title: Availability, Use, and Public Health Impact of Emergency Supply Kits among Disaster-Affected Populations
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: 08/03/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/08/2021
Terms of Clearance: CDC will submit a nonsubstantive change with the approved template, in advance of collection, to provide the details, sampling plan, and nature of the disaster.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	24 Months From Approved
Responses	1,048	0	0
Time Burden (Hours)	384	0	0
Cost Burden (Dollars)	9,857	0	0

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Abstract: The goal of this study is to determine the efficacy and public health impact of emergency supply kits among disaster-affected populations. This study will attempt to understand how emergency supply kits are used during and after a natural disaster, if public health outcomes (e.g., self-sufficienty, decreased disease exacerbation) are associated with access to emergency supply kits, and what the most useful iterms to include in an emergency supply kit are across different types of disasters.

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Authorizing Statute(s): US Code: 42 USC 301 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:
	85 FR 53377	08/28/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 8646	02/08/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Focus group discussion guide
Focus group screener	none	Focus Group screener
Questionnaire - paper-based	none	Survey questionnaire
Questionnaire - web-based	none	Survey questionnaire - web-based

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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	1,048	0	0	1,048	0	0
Annual Time Burden (Hours)	384	0	0	384	0	0
Annual Cost Burden (Dollars)	9,857	0	0	9,857	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: $225,303

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

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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: 02/08/2021

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