OMB Control No: 0920-1154
ICR Reference No:
202503-0920-028
Status: Active
Previous ICR Reference No: 202210-0920-013
Agency/Subagency: HHS/CDC
Agency Tracking No:
0920-1154-25-0061
Title: [OS] CDC/ATSDR Formative
Research and Tool Development
Type of Information Collection: No
material or nonsubstantive change to a currently approved
collection
Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved
without change
Conclusion Date: 05/09/2025
Retrieve
Notice of Action (NOA)
Date Received in OIRA:
05/01/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2026
03/31/2026
03/31/2026
Responses
75,000
0
75,000
Time Burden (Hours)
60,000
0
60,000
Cost Burden (Dollars)
0
0
0
Abstract: CDC/ATSDR requests an extension of a
generic clearance to conduct formative research for developing new
tools and methodologies to support agency research, surveillance,
and program evaluation activities, and the development and
assessment of multi-use tools. Non-Substantive Change Request
submitted to modify language for compliance with EO 14168
Authorizing Statute(s): US Code:
42
USC 241 Name of Law: PHSA
Citations for New Statutory
Requirements: None
Associated Rulemaking
Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices &
Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR
43860
07/22/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR
62852
10/17/2022
Did the Agency receive public comments on
this ICR? No
Number of Information Collection (IC) in this
ICR: 49
IC Title
Form No.
Form Name
(NCEZID) Focus Groups
with Infectious Disease Physicians and Pharmacists on Antifungal
Therapeutic Drug Monitoring
n/a, n/a
Antifungal TDM
Focus Group Screener , Antifungal TDM Focus Group
Guide
Creative Concept
Testing on Antimicrobial Resistance
0920-1154, 0920-1154, 0920-1154, 0920-1154
Focus Group
Screener for Consumers, Including Parents , Interview Screener for
Healthcare Providers , Focus Group Guide for
Consumers about Antimicrobial Resistance Concept Testing ,
Interview Guide
for Healthcare Professionals about Antimicrobial Resistance Concept
Testing
Feedback Survey for
Community Counts Data Viz Tool
0920-1154
Feedback Survey
for Community Counts Data Viz Tool
Formative Research for
Spanish-Language Drug Overdose Messages
n/a, n/a, n/a, n/a, n/a, n/a
Qualitative
Eligibility Screener (Phone) , Qualitative Eligibility
Screener (Online) , Focus Group Moderator
Guide , Interview Guide ,
Online Survey ,
Respondent
Consent Form and Participants Email
In-Depth Interviews
with Healthcare Professionals about C. Diff Materials
0920-1154-24ES, 0920-1154-24ES
Antimicrobial
Resistance Communications and Media Support Services ,
Antimicrobial
Resistance Communications and Media Support Services_Guide HCPs
(24ES)
Message Evaluation for
CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad
Surveys)
0920-1154, 0920-1154
Stop Overdose
Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey -
Broadcast Radio , Stop Overdose Campaign
Evaluation: Fentanyl and Naloxone Campaigns Survey - Digital Ad
[CPR] Evaluation on
Acceptability and Effectiveness of Pilot Project This is a Tabletop
Exercise Simulation Tool (T.E.S.T.)
0920-23DA, 0920- 23DF, 0920-23DF
Attachment
B_Immediate Post Exercise Survey Questions , Attachment C_Follow Up Survey
Questions , Attachment D_Focus Group
Script
[CPR] Pilots
Evaluation of Interventions for Building Resilience for State and
Local Health Department Staff Responding to Public Health
Emergencies
0920-24EB, 0920-24EB, 0920-24EB, 0920-24EB
Pilot Evaluation
Pre-Implementation Survey , Pilot Evaluation
POST-Implementation Survey , Staff Focus Groups ,
Leader Focus
Groups
[CPR] Successes of and
Barriers to Distribution of Personal Protective Equipment (PPE)
During the 2024 Dairy Cattle H5N1 Outbreak
n/a, n/a
Personal
Protective Equipment Key Informant Interviews , Online Survey Questionnaire
(to be amended as appropriate following review of KII
responses)
[CPR] This is a
T.E.S.T.
0920-24GC, 0920-24GC, 0920-24GC
Initial Survey
, Follow- up
Survey , Focus Group
[CSELS/DLS]CDC OneLab
Network Formative Evaluation
0920-1154-24AR
04_Attachment
1_OneLab Network Survey_10-26-2023
[NCBDDD](genIC)
Feedback Survey for Community Counts Data Viz Tool
0920-1154
Feedback Survey
for Community Counts Data Viz Tool
[NCCDPHP] Formative
Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes
Self-Management in Disproportionately Affected Populations (DAPs)
Provider Listening Sessions (Phase I)
None, None, None, None
DSMES Provider
Screener Script and Guidelines , Listening Sessions Guide for
Providers Who Support People with Learning Disabilities ,
Listening
Sessions Guide for Providers Who Support Minority Women ,
Listening
Sessions Guide for Providers Who Support People with Mental Health
Disorders
[NCEH] Evaluating
Content and Usability of CDC's Clinical Heat Guidance
0920-1154, 0920-1154, 0920-1154, 0920-1154
Physician - Survey
for Community Health Center Physicians and Non-Physicians on CDC’s
Clinician Heat Guidance , Non-Physician - Survey for
Community Health Center Physicians and Non-Physicians on CDC’s
Clinician Heat Guidance , Physician - Survey for
Community Health Center Physicians and Non-Physicians on CDC’s
Clinician Heat Guidance_Spanish , Non-Physician - Survey for
Community Health Center Physicians and Non-Physicians on CDC’s
Clinician Heat Guidance_Spanish
[NCEZID] (genIC)
Healthcare Provider Communication Evaluation: Assessing Foodborne
Illness and Waterborne Illness Prevention Messages, Knowledge, and
Attitudes
0920-1154, 0920-1154, 0920-1154, 0920-1154
Screening/Eligibility Form for
Interviews/Focus Groups (24CU) , Eligible Participant Screener
(24CU) , Moderator or Interviewer Guide
(24CU) , MESSAGES to be TESTED
(24CU)
[NCEZID] Communication
Evaluation Assessing Foodborne, Waterborne and Mycotic Disease
Prevention
0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154
Eligibility
Screener - Focus Group , Eligible Participant Screener
- Focus Group , Eligibility Screener -
Survey , Focus Group Moderator
Guide , Rapid Online Survey
[NCEZID] Focus Groups
with Healthcare Providers on Endemic Mycoses
n/a, n/a, n/a
Focus Group
Screener , Focus Group Consent Form ,
Focus Group
Guide
[NCEZID] Food Safety
Communication Evaluation: Assessing Food Safety Messages,
Knowledge, and Attitudes
None, None, None, None, None
Eligibility
Screener for Focus Group , [Additional] Eligible
Participant Screener for Focus Group , Focus Group Moderator
Guide , Eligibility Screener for Rapid
Survey , Rapid Survey
[NCEZID] Harmful Algal
Blooms Communication Evaluation
0920-1154, 0920-1154, 0920-1154
Screening/Eligibility Form for
Focus Groups (24CX) , Eligible Participant Screener
for Focus Group (24CX) , Focus Group Moderator Guide
(24CX)
[NCEZID] Hospital
System Approach to Collecting Race, Ethnicity, and Language
Data
092061154
NHSN’s REaLI
Effort
[NCEZID] In-depth
Interviews with Hispanic or Latina Women on the Topic of Climate
Change and Infectious Diseases
0920-1154, 0920-1154, 0920-1154
RECRUITMENT
SCREENER In-Depth Interviews with Hispanic or Latina Women ,
CONSENT FORM
In-Depth Interviews with Hispanic or Latina Women ,
MODERATOR INTERVIEW
GUIDE In-Depth Interviews with Hispanic or Latina Women
[NCEZID] Public Health
Communications Messages and Materials Testing Focused on
Antimicrobial Resistance Among the U.S. General Population Pilot
Data Collection Project
n/a, n/a, n/a
Recruitment
Screener , Technology Pre-check ,
AR Formative
Evaluation Interview Guide
[NCEZID] Wastewater
Surveillance Communication Evaluation: Assessing Water Surveillance
Messages, Knowledge, and Attitudes (24CP)
0920-1154, 0920-1154, 0920-1154
Screening/Eligibility Form for
Focus Groups , Eligible Participant Screener
for Focus Group (24CP) , Focus Group Moderator Guide
(24CP)
[NCIPC] Adolescent
Mental Health Journey Mapping Project
n/a, n/a, n/a, n/a, n/a
Screening Survey and Parental
Consent , LGBTQ+ Teen Screening
Survey ,
Adolescent
Interview Discussion Guide , Adolescent Focus Group
Discussion Guide , Adolescent Brainstorming
Session Discussion Guide
[NCIPC] Adoption
Accelerator Social Network Analysis (Formative Research)
0920-24GZ
Sheriffs’
Advice-Seeking Survey
[NCIPC] Adverse
Childhood Experiences Prevention Message Development
0920-1154, 0920-1154 , 0920-1154 (24IP), 0920-1154 (24IP),
0920-1154 (24IP)
ACEs Survey and
Consent - Revised 25MAR2025 , ACEs Focus Group Participant
Screener - Revised 25MAR2025 , ACEs Focus Group Consent
Form ,
ACEs Partner Interview
Consent Form , ACEs Partner Interview
Guide
[NCIPC] Caring Adults
Perceptions on Teen Mental Health
0920-1154 (24HL), 0920-1154 (2HL)
ADULT MENTOR SCREENING
SURVEY ,
INTERVIEW
DISCUSSION GUIDE
[NCIPC] Caring Adults
Perceptions on Teen Mental Health
0920-24HY
Screening
Survey
[NCIPC] Formative
Evaluation for Transportation Safety Resource for Action
Tool
n/a, n/a, n/a, n/a
Email
Invitation , First Follow-up Email ,
Second
Follow-up Email , Semi-Structured Interview
Guide
[NCIPC] Formative
Research for Firearm Violence and Community Violence
Messaging
n/a, n/a, n/a, n/a, n/a, n/a
Firearm Injury and
Death Survey and Consent , Firearm Injury and Death Focus
Group , Firearm Injury and Death Focus
Group Screening , Community Violence Survey and
Consent , Community Violence Focus
Group , Community Violence Focus Group
Screening
[NCIPC] Screening
Survey for focus groups and interviews
0920-1154-24CC, 0920-1154 (24CC), 0920-1154 (24CC)
Recruitment
Materials - Focus Groups and Interviews - AI/AN Adults , Focus Group Guide AI/AN
Adults , Interview Guide Tribal Health
Care Providers (HCPs) and Tribal Leaders
[NCIPC] Youth Audience
Message Testing of Substance Use Prevention Messages
n/a, n/a
Parent and Child
Screeners
, Activity Guide
[NCZEID] CDC One
Health Zoonotic Disease Prioritization (OHZDP) Evaluation
Process
0920-24EH, 0920-24EH, 0920-24EH, 0920-24EH, 0920-24EH,
0920-24EH, 0920-24EH
OHZDP Interest
Intake Form , OHZDP Baseline Survey ,
OHZDP
Facilitator Training Survey , OHZDP Participant Survey ,
OHZDP Next
Steps Tracker , OHZDP Post Workshop Survey
, OHZDP
Retrospective Survey
[NCZEID] Focus Groups
and In-Depth Interviews with Travelers and Travel Medicine
Specialists
0920-24ID, 0920-24ID, 0920-24ID, 0920-24ID, 0920-24ID,
0920-24ID
Recruitment
Screener , Consent Form ,
Focus Group Guide
, Interview
Recruitment Screener , Travel Med Specialists -
Consent Form , Travel Med Specialists -
Interview Guide
[NCZEID] Focus Groups
and Interviews with Consumers and HCPs on Alpha-Gal
Syndrome
0920-24CA, 0920-24CA, 0920-24CA, 0920-24CA
Attachment 1 - CDC
DVBD - AGS Data Collection - Focus Group Screener - 12.14.23 ,
Attachment 5 -
CDC DVBD - AGS Data Collection - Focus Group Discussion Guide -
12.14.23 , Attachment 2 - CDC DVBD - AGS
Data Collection - Interview Screener - 12.14.23 ,
Attachment 6 - CDC
DVBD - AGS Data Collection - Interview Discussion Guide -
12.14.23
[NCZEID] Focus Groups
with Consumers on Oropouche
0920-25BP, 0920-25BP
Focus Group
Screener , Focus Group Discussion
Guide
[NCZEID] Formative
Communications Assessment on Antimicrobial Resistance
0920-24DM, 0920-24DM, 0920-24DM, 0920-24DM, 0920-24DM,
0920-24DM, 0920-24DM, 0920-24DM, 0920-24DM
Focus Group
Screener , Focus Group Guide for HCPs
about Antimicrobial Resistance , Interview Guide for Medical
Association about Antimicrobial Resistance , Focus Group Screener for
Consumers, Including Parents, and Caregivers , Focus Group Guide for General
Consumers about Antimicrobial Resistance , Focus Group Guide for
Caregivers about Antimicrobial Resistance , In-Depth Interview Screener
for Consumers with Previous Antimicrobial-Resistant Infections
, Interview
Guide for Consumers with Past Antimicrobial Resistant Infections on
Antimicrobial Resistance , Survey on Antimicrobial
Resistance Among National Policy Audiences
[NCZEID] Formative
Evaluation and Message Testing of Antimicrobial Resistance Among
Sandwich Generation Consumers
0920-25BU, 0920-25BU, 0920-25BU
Sandwich
Generation Consumer Survey , Sandwich Generation
ConsumerScreener , Sandwich Generation Consumer
Focus Group Discussion Guide
[NCZEID] Harmful Algal
Blooms Shellfish Communication Evaluation
25-0003, 25-0003, 25-0003
Screener ,
Eligibility
Screener , Moderator Guide
[NICPC] Child Abuse
and Neglect Prevention Message Development
0920-24BQ, 0920-24BQ, 0920-24BQ
Att 1. CAN Survey
and Consent , Att 3. CAN Focus Group
Eligible Participant Screener 11.21.23 , Att 3. CAN Focus Group
Eligible Participant Screener rev
[NIOSH] Assessment of
Task-Based Exposures That May Affect Reproductive Health in Nail
Salon Employees
0920-1154, 0920-1154 (24AA)
Nail Salon
Exposure Study Questionnaire (24AA) , Nail Salon Exposure Study
Questionnaire Feedback Form
[NIOSH] Assessment of
Task-Based Exposures that may Affect Reproductive Health in Nail
Salon Employees
0920-1154, 0920-1154
Nail Salon
Exposure Study Questionnaire (24FD) , Nail Salon Exposure Study
Questionnaire Feedback Form (24FD)
[NIOSH] Developing a
Framework to Identify and Address Job Hazards Unique to Women Mine
Workers
n/a, n/a, n/a
Focus Group
Conversation Guide for Women Mine Workers , Focus Group Conversation Guide
for Mine Managers and HS Professionals , Demo
[NIOSH] Formative
Assessment of the Information Needs to Prevent Skin Cancer Among
Spanish speaking Outdoor Workers
0920-23GU
Attmt III- Focus
Group Guide - English_Spanish
[NIOSH] Increasing the
Impact of NIOSH Heat Stress Products in Outdoor Worker
Populations
n/a, n/a, n/a, n/a
Focus Group Guide
for Employers/Supervisors , Focus Group Guide for
Employees - English/Spanish , Training for Employers -
Pre-test , Training for Employers -
Post-test
[NIOSH] Keeping Cool:
Evaluating NIOSH's Heat Stress Training Module to Inform Resource
Development and Research
0920-1154, 0920-1154, 0920-1154, 0920-1154, 0920-1154,
0920-1154
Script for Initial
Interview with OSH Managers and Trainers , Script for Post-Preparation
Interview with Osh Managers and Trainers (Prior to Training) ,
Script for
POST-TRAINING INTERVIEW with OSH Managers and Trainers ,
Employee Survey ,
Employee Focus
Group Questions , NIOSH Heat Stress Training
Log
[NOISH] Customer
Discovery Interviews with Five NIOSH Audiences
[OLSS] CDC OneLab
REACH Formative Evaluation
n/a, n/a, n/a, n/a, n/a
Single Sign-Up
Survey , Post Course Evaluation
Survey , User Experience Survey ,
Mini Lesson and
Job Aid Survey , Pace and non-Pace Evaluation
Survey
[OPHDST] Foundational
User Interviews with the Public
0920-1154, 0920-1154
Foundational
Screener (25AB) , Foundational Data Collection
Interview Scripts (25AB)
ICR Summary 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
75,000
75,000
0
0
0
0
Annual Time Burden (Hours)
60,000
60,000
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency
Discretion: No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency
Discretion: No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government: $474,091
Does this IC contain surveys, censuses, or employ
statistical methods? No
Does this ICR request any personally identifiable
information (see OMB Circular No. A-130 for an
explanation of this term)? Please consult with your agency's
privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act
Statement (see 5
U.S.C. §552a(e)(3) )? Please consult with your agency's privacy
program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L.
111-148 & 111-152]? No
Is this ICR related to the Dodd-Frank Wall Street Reform
and Consumer Protection Act, [Pub. L. 111-203]? No
Is this ICR related to the American Recovery and
Reinvestment Act of 2009 (ARRA)? No
Is this ICR related to the Pandemic Response?
No
Agency Contact: Jeffrey Zirger 404 639-7118
[email protected]