Information Collection Request

[NCCDPHP] Cognitive Testing and Pilot Testing for the National Center for Chronic Disease Prevention and Health Promotion

ICR 202301-0920-011 · OMB 0920-1291 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Cognitive Testing Questions Form New Repair queued
Web and CATI Survey BRFSS Pilot Form and Instruction New Repair queued
Form 0920-1291 Panel Core Questions Form and Instruction New Available
Form 0920-1291 CDC Questionnaire - BRFSS subset Form and Instruction New Available
NCCDPHP GCT Cover Form Final.docx Supplementary Document Uploaded 2023-01-19 Repair queued
GCT 1291 Att 6 Part Screener.docx Supplementary Document Uploaded 2023-01-19 Repair queued
GCT 1291 Att 5 Vendor Cog Tstng Rpt.docx Supplementary Document Uploaded 2023-01-19 Repair queued
GCT 1291 Att 4 NCCDPHP Divisions.docx Supplementary Document Uploaded 2023-01-19 Repair queued
GCT 1291 Att 3 Proposal Process Quest.docx Supplementary Document Uploaded 2023-01-19 Repair queued
GCT 1291 Att 1 Auth Leg.pdf Supplementary Document Uploaded 2023-01-19 Repair queued
0920 1291 Chg Req 11-12-2020.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-11-12 Repair queued
GCT 1291 SSA_Revised.docx Supporting Statement A Uploaded 2023-01-27 Repair queued
Att 9. NCCDPHP GCT Cover Form Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 7. NCCDPHP GCT Multimode Pilot Final Report Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 6. NCCDPHP GCT Screener to Participate in Cognitive Testing Exam Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 5. NCCDPHP GCT Vendor Cognitive Testing Rpt Exam Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 4. NCCDPHP GCT NCCDPHP Divisions Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 3. NCCDPHP GCT Quest Proposal Proc Exam from the BRFSS Final.docx Supplementary Document Uploaded 2019-12-16 Repair queued
Att 2. Published 60-day FRN Final.pdf Supplementary Document Uploaded 2019-12-16 Repair queued
Att 1. NCCDPHP GCT Authorizing Legislation Final.pdf Supplementary Document Uploaded 2019-12-16 Repair queued
GCT 1291 SSB.docx Supporting Statement B Uploaded 2023-01-19 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
269753 [NCCDPHP] Cognitive Testing and RDD Push-to-Web Pilot Testing for BRFSS Form NewCognitive Testing Questions
269753 [NCCDPHP] Cognitive Testing and RDD Push-to-Web Pilot Testing for BRFSS Form and Instruction NewWeb and CATI Survey BRFSS Pilot
260937 [NCCDPHP] Pilot Testing of State-Level Prevalence Estimation Using a YouGov Internet Panel Form and Instruction NewPanel Core Questions
260937 [NCCDPHP] Pilot Testing of State-Level Prevalence Estimation Using a YouGov Internet Panel Form and Instruction NewCDC Questionnaire - BRFSS subset
260865 [NCCDPHP] Cognitive testing and RDD push-to-web pilot testing Other-WORD New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2026 36 Months From Approved 05/31/2023
270,300 0 270,300
35,850 0 35,850
0 0 658,900





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
[NCCDPHP] Cognitive Testing and RDD Push-to-Web Pilot Testing for BRFSS n/a, n/a ,  
[NCCDPHP] Cognitive testing and RDD push-to-web pilot testing
[NCCDPHP] Pilot Testing of State-Level Prevalence Estimation Using a YouGov Internet Panel 0920-1291, 0920-1291 ,  

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 270,300 270,300 0 -270,300 270,300 0
Annual Time Burden (Hours) 35,850 35,850 0 -107,550 107,550 0
Annual Cost Burden (Dollars) 0 658,900 0 -658,900 0 0


Reginfo record details
  No