Approved Privacy Narrative

Date
02/13/2024

Information Collection Request - Privacy Narrative

Evaluation of an Online Prostate Cancer Screening Decision Aid
Title: ______________________________________________________________________________________
David Siegel, MD, MPH
Point of Contact: _____________________________________________________________________________

Description
CDC and the contractor do not intend to retrieve or file information in identifiable form in a data
collection system. Patients will provide information on their awareness, knowledge, attitudes towards
prostate cancer screening and decisions about screening. The clinic coordinators will provide their
feedback on the barriers and best practices for incorporating the decision aid into the clinic flow. The
providers will share their prostate cancer screening practices and attitudes towards prostate cancer
screening. The name and email addresses of providers and eligible patients will be provided by four
clinics and will be used to recruit, determine eligibility, and enroll providers and patients into the study.
Participants selected for the study will be assigned a unique ID number by the survey platform. Any
data collected in the Voxco survey platform will NOT be connected to the names and email addresses
of these individuals. Email addresses will be used only to send links to surveys and reminders to
complete the surveys. The contact information will be maintained until the end of the data collection
but will not be connected to the data collected through the surveys. The patients and clinic study
coordinators will be assigned numbers. All provider, patient, and clinic coordinators will be provided
with consent statements prior to beginning each data collection.
All identifying information will be maintained in a separate Excel sheet that is password-protected and
on a secure server accessible only through password-protected computers used by key ICF staff. The
email addresses and names will not be linked to the survey or interview data. All data collected will be
stored on ICF's secure server to protect and maintain information collected through this evaluation.
All information will be maintained confidentially and securely. Data will be analyzed and reported in
aggregate. ICF will retain data materials, including audio files, interview transcripts, and all other
electronic files in archives for at least 3 years after the expiration or termination of the contract.
Electronic data will be archived in a password-protected project folder. Destruction of all hard copy
documents will be accomplished through shredding and electronic files will be deleted. Following the
study, CDC will release the de-identified data set to the public.

Does this ICR request any PII?

✔ Yes

No

Names & email of providers & patients
If yes, describe: _____________________________________

Does this ICR include a form that requires a Privacy Act Statement?
Does this ICR require a PIA?

Yes

✔

No

Yes

✔

No

If yes, does a signed PIA already exist?

C/I/O Approval
Associate Director for Science

Joan Redmondleonard -S
Comments:
for ADS

Digitally signed by Joan
Redmond-leonard -S
Date: 2024.02.15
17:30:25 -05'00'

Information Systems Security Officer

Cynthia
Allen -S

Digitally signed by
Cynthia Allen -S
Date: 2024.02.13
09:03:52 -05'00'

Yes

No