Information Collection

[PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns

IC 268184 under ICR 202410-0920-015 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

2026-08-07 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0879 [PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns	Form and Instruction
Form 0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire [PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns	Form and Instruction
Form 0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire [PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns	Form and Instruction
0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Q Attachment 2 - Programmed Survey_05.21.2024.docx	Form and Instruction
0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Q Attachment 2 - Programmed Survey_05.21.2024.docx	Form and Instruction
0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Q Attachment 1 - Survey Instrument_05.21.2024.docx	Form and Instruction
0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Q Attachment 1 - Survey Instrument_05.21.2024.docx	Form and Instruction
PHIC STLT Generic_SSA_05.28.2024.docx SSA	IC Document
PHIC STLT Generic_SSA_05.28.2024.docx SSA	IC Document
PHIC STLT Generic_SSB_05.28.2024.docx SSB	IC Document
PHIC STLT Generic_SSB_05.28.2024.docx SSB	IC Document
Attachment 3 - Recruitment Email.docx Initial Reach-Out Email Template and Survey Invitation	IC Document
Attachment 3 - Recruitment Email.docx Initial Reach-Out Email Template and Survey Invitation	IC Document
Attachment 4 - Reminder Email.docx REMINDER Email (Survey Request for OD2A Grantees)	IC Document
Attachment 4 - Reminder Email.docx REMINDER Email (Survey Request for OD2A Grantees)	IC Document
Attachment 5 - Final Reminder Email.docx Final Reminder Email (Closing soon: Survey for OD2A Grantees)	IC Document
Attachment 5 - Final Reminder Email.docx Final Reminder Email (Closing soon: Survey for OD2A Grantees)	IC Document
Attachment 6 - Respondent Universe_updated.docx Respondent Universe	IC Document
Attachment 6 - Respondent Universe_updated.docx Respondent Universe	IC Document
Attachment 7 - Project Determination_OD2A.pdf Project Determinatino (24GD)	IC Document
Attachment 7 - Project Determination_OD2A.pdf Project Determinatino (24GD)	IC Document
Attachment 8 - OD2A Campaign Assessment-PTA_20240524.pdf PIA (20240524)	IC Document
Attachment 8 - OD2A Campaign Assessment-PTA_20240524.pdf PIA (20240524)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns

Agency IC Tracking Number:

0920-0879-24GD

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0879				Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879				Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA		06/04/2024
SSB		06/04/2024
Initial Reach-Out Email Template and Survey Invitation		06/04/2024
REMINDER Email (Survey Request for OD2A Grantees)		06/04/2024
Final Reminder Email (Closing soon: Survey for OD2A Grantees)		06/04/2024
Respondent Universe		06/04/2024
Project Determinatino (24GD)		06/04/2024
PIA (20240524)		06/04/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].