Privacy Assessment

PN 0920 0909.pdf

[NCCDPHP] CDC Diabetes Prevention Recognition Program (DPRP)

Privacy Assessment

OMB: 0920-0909

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Information Collection Request - Privacy Narrative
National Diabetes Prevention Program (National DPP) Diabetes Prevention Recognition
Title: ______________________________________________________________________________________
Program (DPRP) Standards

Point of Contact: _____________________________________________________________________________
Stephanie Gruss, PhD, MSW (NCCDPHP/DDT/PIB)
Description
Respondents to this information collection request will be National Diabetes Prevention Program's (National
DPP's) Diabetes Prevention Recognition Program (DPRP) organizational-level directors and managers, and
delivery site-level program coordinators and lifestyle coaches. These are organizations offering CDC's yearlong,
evidence-based lifestyle change program to prevent or delay type 2 diabetes. CDC will not receive any
Personally Identifiable Information (PII) from individual participants who enrolled in the National DPP lifestyle
change program. Electronic responses will not be directly linked to actual program participants. The application
and evaluation forms do not collect participants' PII. The organizations participating in the CDC's DPRP will
follow the 2024 DPRP Standards and Operating Procedures (DPRP Standards) to assign each participant a
unique, de-identified “Participant ID” to track participants across sessions. CDC's DPRP Standards expressly
state, “The Participant ID should not be based on social security number or other PII.”
CDC will collect information from CDC-recognized DPRP Organizations. Each organization applying for CDC
recognition must submit the organization name, plus the job title and email address of the employees
designated to serve as a program director/manager, program coordinator, or data preparer. CDC will use this
information to generate an organizational profile and provide unique organization IDs for authorized staff. The
organization's profile will include business contact and e-mail addresses that are publicly available. The
organizations will report on DPRP Standards-related evaluation data elements at the participant level in a
de-identified manner, issuing each participant with a unique Participant ID. Organizations will not submit any
individual identifiable participant information to CDC.
CDC will use a de-identified National Provider Identifier (NPI) as the Coach ID for coaches registered to deliver
the Centers for Medicare & Medicaid Services (CMS)'s Medicare Diabetes Prevention Program (MDPP). The
lifestyle coach profiles will include their organizational email addresses for the sole purpose of communication
and system login for data entry. CDC does not collect any other PII regarding lifestyle coaches.

Does this ICR request any PII?

✔ Yes

No

business contact information
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

Terri Stilllemelle -S

Digitally signed by Terri
Still-lemelle -S
Date: 2024.04.03
06:17:14 -04'00'

Comments:
Signed on behalf of Rachel Kaufmann.

Information Systems Security Officer

Cynthia
Allen -S

Digitally signed by
Cynthia Allen -S
Date: 2024.04.02
18:38:24 -04'00'

Yes

No


File Typeapplication/pdf
File TitleInformation Collection Request - Privacy Narrative
SubjectInformation Collection Request - Privacy Narrative, ICR, PII
AuthorCenters for Disease Control and Prevention (CDC)
File Modified2024-04-03
File Created2019-07-10

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