[NCHHSTP] Barriers and Facilitators to Expanding the NHBS to Conduct HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Recruiter Debriefing Form (Spanish)	Form and Instruction	Unchanged	Available
Recruiter Debriefing Form (English)	Form and Instruction	Unchanged	Available
Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	Unchanged	Repair queued
Form 0920-1262 Behavioral Assessment (Spanish)	Form and Instruction	Modified	Available
Form 0920-1262 Behavioral Assessment (English)	Form and Instruction	Modified	Available
Form 0920-1262 Eligible and consenting participants - Behavioral Assessment Interview	Form and Instruction	Modified	Repair queued
Eligibility Screener (Spanish)	Form and Instruction	Unchanged	Available
Eligibility Screener (English)	Form and Instruction	Unchanged	Available
18 years old - Eligibility Screener	Form and Instruction	Unchanged	Repair queued
0920-1262_Change_Request_12192022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-01-06	Repair queued
Att 15_Response rate calculations.docx	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 14_Model recruitment coupon.docx	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 13_List of PS22-2201 NHBS-Trans Applicants.docx	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 12_Sample analysis tables.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 11_ Model Consent Form for Survey Activities_rev 12192022.docx	Supplementary Document	Uploaded 2023-01-06	Repair queued
Att 10_Project Determination (Approved 9-13-21).pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 9_Auth to Operate for DCC.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 8_Agreement to abide by restrictions.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 7_Assurance of Confidentiality.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 6_PIA From NHBS-Trans.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 3_Summary of Changes to Data Collection.docx	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 2a_Public Comments.docx	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 2_60-day FRN 11 2 21.pdf	Supplementary Document	Uploaded 2022-03-21	Repair queued
Att 1_Sect 301 PHSA.PDF	Supplementary Document	Uploaded 2022-03-21	Available
Supporting Statement B_03092022.docx	Supporting Statement B	Uploaded 2022-03-21	Repair queued
Supporting Statement A_03092022.docx	Supporting Statement A	Uploaded 2022-03-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234908	Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	Unchanged	Recruiter Debriefing Form (Spanish)
234908	Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	Unchanged	Recruiter Debriefing Form (English)
234908	Peer Recruiters - Recruiter Debriefing Form	Form and Instruction	Unchanged
234907	Eligible and consenting participants - Behavioral Assessment Interview	Form and Instruction	Modified	Behavioral Assessment (Spanish)
234907	Eligible and consenting participants - Behavioral Assessment Interview	Form and Instruction	Modified	Behavioral Assessment (English)
234907	Eligible and consenting participants - Behavioral Assessment Interview	Form and Instruction	Modified
234906	Transgender Women > 18 years old - Eligibility Screener	Form and Instruction	Unchanged	Eligibility Screener (Spanish)
234906	Transgender Women > 18 years old - Eligibility Screener	Form and Instruction	Unchanged	Eligibility Screener (English)
234906	18 years old - Eligibility Screener	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1262	ICR Reference No: 202301-0920-002
Status: Historical Active	Previous ICR Reference No: 202202-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1262-23BS
Title: [NCHHSTP] Barriers and Facilitators to Expanding the NHBS to Conduct HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/12/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/09/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2025	10/31/2025	10/31/2025
Responses	4,340	0	4,340
Time Burden (Hours)	1,108	0	1,108
Cost Burden (Dollars)	0	0	0

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Abstract: CDC proposes to update the Model Consent Form. The revised version is based on the CDC’s Medical Monitoring Project OMB Control No: 0920-0740 as a template. This new version includes all the required elements of informed consent (45 CFR 46.116(a)) and is more concise and respondent friendly. It includes visuals that streamline redundant text and aid comprehension.

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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:
	86 FR 60463	11/02/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 15430	03/18/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Eligible and consenting participants - Behavioral Assessment Interview	0920-1262, 0920-1262	Behavioral Assessment (English) ,   Behavioral Assessment (Spanish)
Peer Recruiters - Recruiter Debriefing Form	None, None	Recruiter Debriefing Form (English) ,   Recruiter Debriefing Form (Spanish)
Transgender Women > 18 years old - Eligibility Screener	None, None	Eligibility Screener (English) ,   Eligibility Screener (Spanish)

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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	4,340	4,340	0	0	0	0
Annual Time Burden (Hours)	1,108	1,108	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,772,886

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: 01/09/2023

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