[NCHHSTP] Performance Measurement for STD Prevention (carryover to 2023-2025)

The Performance Measures Project: Improving Performance Measurement and Monitoring by CDC Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1282 can be found here:

Documents and Forms

Document Name Document Type
[NCHHSTP] Performance Measurement for STD Prevention (carryover to 2023-2025) Form and Instruction
STD PCHD Performance Measurement Att 1_Data Collection Tool_02242020.xlsx Form and Instruction
STD PCHD Performance Measurement Att 1_Data Collection Tool_02242020.xlsx Form and Instruction
PPEO GenIC Template_PS19-1901_2023-2025.docx GenIC Request Template STD Prevention PS19-1901 (carryover 2023-2025) IC Document
PPEO GenIC Template_PS19-1901_2023-2025.docx GenIC Request Template STD Prevention PS19-1901 (carryover 2023-2025) IC Document
Att 2_Notification Email.v2.docx Notification Email IC Document
Att 2_Notification Email.v2.docx Notification Email IC Document
Att 3 STD PCHD Overview and Logic Model.pdf Overview and Logic Model for PS19-1901 STD PCHD IC Document
Att 3 STD PCHD Overview and Logic Model.pdf Overview and Logic Model for PS19-1901 STD PCHD IC Document

Information Collection (IC) Details

IC Title:	[NCHHSTP] Performance Measurement for STD Prevention (carryover to 2023-2025)	Agency IC Tracking Number:	0920-20KO

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	STD PCHD Performance Measurement	Att 1_Data Collection Tool_02242020.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 177	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	177	177
Annual IC Time Burden (Hours)	5,310	5,310
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Template STD Prevention PS19-1901 (carryover 2023-2025)	PPEO GenIC Template_PS19-1901_2023-2025.docx	01/30/2023
Notification Email	Att 2_Notification Email.v2.docx	01/30/2023
Overview and Logic Model for PS19-1901 STD PCHD	Att 3 STD PCHD Overview and Logic Model.pdf	01/30/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.