Information Collection

[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations

IC 261054 under ICR 202503-0920-028 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction
Focus Group Guide for Employers/Supervisors [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction
Focus Group Guide for Employees - English/Spanish [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction
Training for Employers - Pre-test [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction
Training for Employers - Post-test [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction
Attmt G-Recruitment_Consent_Form_English_Spanish 7-13-2023.docx	Other-Consent
Attmt G-Recruitment_Consent_Form_English_Spanish 7-13-2023.docx	Other-Consent
Focus Group Guide for Employers/Supervisors Attmt B- Focus Group Guide for Employers_Supervisors.docx	Form and Instruction
Focus Group Guide for Employers/Supervisors Attmt B- Focus Group Guide for Employers_Supervisors.docx	Form and Instruction
Focus Group Guide for Employees - English/Spanish Attmt C_ Focus Group Guide for Employees_English and Spanish 7-13-23.docx	Form and Instruction
Focus Group Guide for Employees - English/Spanish Attmt C_ Focus Group Guide for Employees_English and Spanish 7-13-23.docx	Form and Instruction
Training for Employers - Pre-test Attmt D- Training for Employers Pre Test Questions.docx	Form and Instruction
Training for Employers - Pre-test Attmt D- Training for Employers Pre Test Questions.docx	Form and Instruction
Training for Employers - Post-test Attmt E- Training for Employers Post test Questions.docx	Form and Instruction
Training for Employers - Post-test Attmt E- Training for Employers Post test Questions.docx	Form and Instruction
Attmt A- Authorizing Legislation.docx Authorizing Legislation	IC Document
Attmt A- Authorizing Legislation.docx Authorizing Legislation	IC Document
Attmt F- IRB determination.pdf Human Subjects Determination	IC Document
Attmt F- IRB determination.pdf Human Subjects Determination	IC Document
Supporting Statement A_final.docx SSA	IC Document
Supporting Statement A_final.docx SSA	IC Document
Supporting Statement B_Heat_Jacklitsch.docx SSB	IC Document
Supporting Statement B_Heat_Jacklitsch.docx SSB	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations

Agency IC Tracking Number:

0920-1154-23GV

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Yes	No	Fillable Fileable
Form and Instruction	n/a	Yes	No	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Other-Consent		Yes	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 504

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 26 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	504	504
Annual IC Time Burden (Hours)	539	539
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Authorizing Legislation		07/17/2023
Human Subjects Determination		07/17/2023
SSA		07/17/2023
SSB		07/17/2023

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

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