GenIC Request

Request for genIC Approval

CDC/ATSDR Formative Research and Tool Development

0920-1154

CIO: Office of Readiness and Response

PROJECT TITLE: Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies

PURPOSE AND USE OF COLLECTION:

This data collection is designed to assess the implementation of strategies designed to improve resilience or reduce burnout and/or stress for health department staff. It is part of a larger study that first involved a landscape assessment to understand causes of burnout in health department staff and strategies that have effectively been used to address these causes and improve resilience or reduce burnout and/or stress. The goal of the pilot implementation is to evaluate interventions in a public health department setting to determine those interventions that will be the most beneficial to the health department workforce. The data collection will also provide results that will support developing final tools that can be used to implement these strategies across health departments. The research team will support the implementation of the interventions, and as part of this support will conduct assessments to evaluate the effectiveness of the interventions and how they are implemented. This information will be used to select interventions and tools to include in the ultimate toolkit, as well as to identify updates that may be needed to the interventions to make them more applicable in state, local, tribal, and territorial health departments.

DESCRIPTION OF RESPONDENTS:

The target population for this assessment will include leaders and staff of state and local public health departments who are participating in the pilot implementation of an identified strategy through their employer (i.e., the health department). However, if there are other STLT departments or associations (e.g., emergency management organizations, mental health organizations) that work closely with health departments but are not technically part of the departments, they may be included as well. The following groups of people will be specifically included in the data collection:

• Health department leaders and program leaders/strategy implementation leaders

• Health department staff who are part of the health department participating in the strategy pilot.

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. Information gathered will not be used to substantially inform influential policy decisions.

5. The study is not intended to produce results that can be generalized beyond its scope.

Name: _Dr. Allison Alexander__________________________________________

To assist review, please answer the following questions:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	Form Name	No. of Respondents	Participation Time (minutes)	Burden in Hours
State, local, or tribal governments	Pilot Evaluation Pre-Implementation Survey	400	10	67
State, local, or tribal governments	Pilot Evaluation Post-Implementation Survey	400	20	133
State, local, or tribal governments	Pilot Evaluation – Staff Focus Groups	60	60	60
State, local, or tribal governments	Pilot Evaluation – Leader Focus Groups	24	60	24
Totals		884		284

FEDERAL COST: The estimated annual cost to the Federal government is $20,320 (CDC Project officer overseeing project at 0.25 FTE).

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Specific health departments or individual offices/departments within those health departments will be identified and agree to participate in the pilot strategy implementation. As such, the potential respondents are all employees who participate in the pilot. Within the pilot organizations, all staff who are part of the pilot strategy implementation will be invited to complete the pre- and post-implementation surveys. For the focus groups, staff who participate in the pilot will be randomly selected for invitation to the focus groups. Up to 10 staff members and 4 leaders will be randomly selected at each pilot site to share their feedback in the focus groups. The only required qualification for participation will be that each individual was part of the pilot strategy implementation.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [X] Yes [ ] No

Please make sure all instruments, instructions, and scripts are submitted with the request.

Instructions for completing genIC Request for Approval for

CDC/ATSDR Formative Research and Tool Development

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is requested.

PURPOSE and USE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Briefly describe the targeted group/groups for this collection.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

Form: Provide the title of the information collection form.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group).

Burden in Minutes: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Estimate the annual cost to the Federal government for this collection.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

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