[OS] CDC/ATSDR Formative Research and Tool Development

Forms and Documents

Document	Type	Status	Availability
Form 0920-25-0125 ASEAN PHEM WLP Survey	Form	Unchanged	Available
Form 0920-25-0125 [CPR] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey	Form	Unchanged	Repair queued
Form 0920-25-0124 Lyme Disease Screener	Form	Unchanged	Available
Form 0920-25-0124 [NCZEID] Lyme Disease Creative and Message Testing Focus Groups	Form	Unchanged	Available
Interview Guide: Family/Close Friend (Follow-Up Interview)	Form and Instruction	Unchanged	Available
Interview Guide: Resident and Family/Close Friend (Paired Interview)	Form and Instruction	Unchanged	Available
DHQP Interview Screener	Form and Instruction	Unchanged	Available
[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities	Form and Instruction	Unchanged	Repair queued
Form 0920-25-0059 Data_Interview	Form	Unchanged	Repair queued
Form 0920-25-0059 IVMS_Interview	Form	Unchanged	Repair queued
Form 0920-25-0059 MVC_Priorities_Interview	Form	Unchanged	Available
Form 0920-25-0059 [NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged	Missing upstream
Form 0920-25-0088 Conversation guide	Form	Unchanged	Available
Form 0920-25-0088 [OPHDST] CDC ENGAGE Functionality Project	Form	Unchanged	Repair queued
Form 0920-25-0094 Intake Form	Form	Unchanged	Available
Form 0920-25-0094 Key Informant	Form	Unchanged	Repair queued
Form 0920-25-0094 Request	Form	Unchanged	Available
Form 0920-25-0094 [OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged	Repair queued
Form 25-0003 Moderator Guide	Form	Unchanged	Repair queued
Form 25-0003 Eligibility Screener	Form	Unchanged	Available
Form 25-0003 Screener	Form	Unchanged	Repair queued
Form 25-0003 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged	Repair queued
Form 0920-1154 Rapid Online Survey	Form and Instruction	Unchanged	Available
Form 0920-1154 Focus Group Moderator Guide	Form and Instruction	Unchanged	Available
Form 0920-1154 Eligibility Screener - Survey	Form and Instruction	Unchanged	Available
Form 0920-1154 Eligible Participant Screener - Focus Group	Form and Instruction	Unchanged	Available
Form 0920-1154 Eligibility Screener - Focus Group	Form and Instruction	Unchanged	Available
Form 0920-1154 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish	Form and Instruction	Unchanged	Available
Form 0920-1154 Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance	Form and Instruction	Unchanged	Available
Form 0920-1154 Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance	Form and Instruction	Unchanged	Available
Form 0920-1154 [NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged	Available
Form 0920-25BU Sandwich Generation Consumer Focus Group Discussion Guide	Form	Unchanged	Available
Form 0920-25BU Sandwich Generation ConsumerScreener	Form	Unchanged	Repair queued
Form 0920-25BU Sandwich Generation Consumer Survey	Form	Unchanged	Available
Form 0920-25BU [NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers	Form	Unchanged	Repair queued
Form 0920-25BP Focus Group Discussion Guide	Form	Unchanged	Repair queued
Form 0920-25BP Focus Group Screener	Form	Unchanged	Available
Form 0920-25BP [NCZEID] Focus Groups with Consumers on Oropouche	Form	Unchanged	Repair queued
Form 0920-25-0040 Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Repair queued
Semi-Structured Interview Guide	Form and Instruction	Modified	Repair queued
Second Follow-up Email	Form and Instruction	Modified	Available
First Follow-up Email	Form and Instruction	Modified	Available
Email Invitation	Form and Instruction	Modified	Repair queued
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Repair queued
Form 0920-1154 Foundational Data Collection Interview Scripts (25AB)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Foundational Screener (25AB)	Form and Instruction	Unchanged	Available
Form 0920-1154 [OPHDST] Foundational User Interviews with the Public	Form and Instruction	Unchanged	Repair queued
Demo	Form and Instruction	Unchanged	Available
Focus Group Conversation Guide for Mine Managers and HS Professionals	Form and Instruction	Unchanged	Repair queued
Focus Group Conversation Guide for Women Mine Workers	Form and Instruction	Unchanged	Repair queued
[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction	Unchanged	Available
Online Survey Questionnaire (to be amended as appropriate following review of KII responses)	Form and Instruction	Unchanged	Available
Personal Protective Equipment Key Informant Interviews	Form and Instruction	Unchanged	Repair queued
[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24AA) Nail Salon Exposure Study Questionnaire Feedback Form	Form	Unchanged	Repair queued
Form 0920-1154 Nail Salon Exposure Study Questionnaire (24AA)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 [NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24IP) ACEs Partner Interview Guide	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24IP) ACEs Partner Interview Consent Form	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24IP) ACEs Focus Group Consent Form	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 ACEs Focus Group Participant Screener - Revised 25MAR2025	Form and Instruction	Unchanged	Available
Form 0920-1154 ACEs Survey and Consent - Revised 25MAR2025	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 [NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	Repair queued
Form 0920-24ID Travel Med Specialists - Interview Guide	Form	Unchanged	Repair queued
Form 0920-24ID Travel Med Specialists - Consent Form	Form	Unchanged	Repair queued
Form 0920-24ID Interview Recruitment Screener	Form	Unchanged	Available
Form 0920-24ID Focus Group Guide	Form	Unchanged	Available
Form 0920-24ID Consent Form	Form	Unchanged	Repair queued
Form 0920-24ID Recruitment Screener	Form	Unchanged	Repair queued
Form 0920-24ID [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Repair queued
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 [NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Missing upstream
Form 0920-24HY Screening Survey	Form	Unchanged	Available
Form 0920-24HY [NCIPC] Caring Adults Perceptions on Teen Mental Health	Form	Unchanged	Repair queued
Adolescent Brainstorming Session Discussion Guide	Form and Instruction	Unchanged	Available
Adolescent Focus Group Discussion Guide	Form and Instruction	Unchanged	Available
Adolescent Interview Discussion Guide	Form and Instruction	Unchanged	Available
LGBTQ+ Teen Screening Survey	Form and Instruction	Unchanged	Repair queued
Screening Survey and Parental Consent	Form and Instruction	Unchanged	Available
Form 0920-1154 (2HL) INTERVIEW DISCUSSION GUIDE	Form and Instruction	Unchanged	Available
Form 0920-1154 (24HL) ADULT MENTOR SCREENING SURVEY	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 NIOSH Heat Stress Training Log	Form	Unchanged	Available
Form 0920-1154 Employee Focus Group Questions	Form	Unchanged	Available
Form 0920-1154 Employee Survey	Form and Instruction	Unchanged	Available
Form 0920-1154 Script for POST-TRAINING INTERVIEW with OSH Managers and Trainers	Form and Instruction	Unchanged	Available
Form 0920-1154 Script for Post-Preparation Interview with Osh Managers and Trainers (Prior to Training)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Script for Initial Interview with OSH Managers and Trainers	Form and Instruction	Unchanged	Available
Form 0920-1154 [NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged	Repair queued
Form 0920-24GZ Sheriffs’ Advice-Seeking Survey	Form	Unchanged	Available
Form 0920-24GZ [NCIPC] Adoption Accelerator Social Network Analysis (Formative Research)	Form	Unchanged	Repair queued
Activity Guide	Form and Instruction	Unchanged	Repair queued
Parent and Child Screeners	Form and Instruction	Unchanged	Repair queued
[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Interview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing	Form and Instruction	Unchanged	Available
Form 0920-1154 Focus Group Guide for Consumers about Antimicrobial Resistance Concept Testing	Form and Instruction	Unchanged	Available
Form 0920-1154 Interview Screener for Healthcare Providers	Form and Instruction	Unchanged	Available
Form 0920-1154 Focus Group Screener for Consumers, Including Parents	Form and Instruction	Unchanged	Available
Form 0920-1154 Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Repair queued
Form 0920-24GC Focus Group	Form	Unchanged	Available
Form 0920-24GC Follow- up Survey	Form	Unchanged	Repair queued
Form 0920-24GC Initial Survey	Form	Unchanged	Available
Form 0920-24GC [CPR] This is a T.E.S.T.	Form	Unchanged	Repair queued
Form 092061154 NHSN’s REaLI Effort	Form	Unchanged	Available
Form 092061154 [NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data	Form	Unchanged	Repair queued
Form 0920-1154 Nail Salon Exposure Study Questionnaire Feedback Form (24FD)	Form	Unchanged	Available
Form 0920-1154 Nail Salon Exposure Study Questionnaire (24FD)	Form and Instruction	Unchanged	Available
Form 0920-1154 [NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged	Repair queued
Leader Focus Groups	Form	Unchanged	Available
Staff Focus Groups	Form	Unchanged	Available
Pilot Evaluation POST-Implementation Survey	Form	Unchanged	Available
Pilot Evaluation Pre-Implementation Survey	Form	Unchanged	Available
[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged	Repair queued
Form 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services	Form and Instruction	Unchanged	Repair queued
Form 0920-1154-24ES In-Depth Interviews with Healthcare Professionals about C. Diff Materials	Form and Instruction	Unchanged	Repair queued
Form 0920-24EH OHZDP Retrospective Survey	Form	Unchanged	Repair queued
Form 0920-24EH OHZDP Post Workshop Survey	Form	Unchanged	Available
Form 0920-24EH OHZDP Next Steps Tracker	Form	Unchanged	Available
Form 0920-24EH OHZDP Participant Survey	Form	Unchanged	Repair queued
Form 0920-24EH OHZDP Facilitator Training Survey	Form	Unchanged	Available
Form 0920-24EH OHZDP Baseline Survey	Form	Unchanged	Available
Form 0920-24EH OHZDP Interest Intake Form	Form	Unchanged	Available
Form 0920-24EH [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	Missing upstream
Form 0920-24DM Survey on Antimicrobial Resistance Among National Policy Audiences	Form	Unchanged	Repair queued
Form 0920-24DM Interview Guide for Consumers with Past Antimicrobial Resistant Infections on Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-24DM In-Depth Interview Screener for Consumers with Previous Antimicrobial-Resistant Infections	Form	Unchanged	Available
Form 0920-24DM Focus Group Guide for Caregivers about Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-24DM Focus Group Guide for General Consumers about Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-24DM Focus Group Screener for Consumers, Including Parents, and Caregivers	Form	Unchanged	Repair queued
Form 0920-24DM Interview Guide for Medical Association about Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-24DM Focus Group Guide for HCPs about Antimicrobial Resistance	Form	Unchanged	Available
Form 0920-24DM Focus Group Screener	Form	Unchanged	Available
Form 0920-24DM [NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-1154 Focus Group Moderator Guide (24CX)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Eligible Participant Screener for Focus Group (24CX)	Form	Unchanged	Available
Form 0920-1154 Screening/Eligibility Form for Focus Groups (24CX)	Form	Unchanged	Available
Form 0920-1154 [NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged	Repair queued
Form 0920-1154 MESSAGES to be TESTED (24CU)	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Moderator or Interviewer Guide (24CU)	Form and Instruction	Unchanged	Available
Form 0920-1154 Eligible Participant Screener (24CU)	Form and Instruction	Unchanged	Available
Form 0920-1154 Screening/Eligibility Form for Interviews/Focus Groups (24CU)	Form	Unchanged	Available
Form 0920-1154 [NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form	Unchanged	Repair queued
Form 0920-1154 Focus Group Moderator Guide (24CP)	Form and Instruction	Unchanged	Available
Form 0920-1154 Eligible Participant Screener for Focus Group (24CP)	Form	Unchanged	Repair queued
Form 0920-1154 Screening/Eligibility Form for Focus Groups	Form	Unchanged	Available
Form 0920-1154 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form	Unchanged	Repair queued
Antifungal TDM Focus Group Guide	Form and Instruction	Unchanged	Repair queued
Antifungal TDM Focus Group Screener	Form and Instruction	Unchanged	Repair queued
(NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring	Form and Instruction	Unchanged	Available
Form 0920-24CA Attachment 6 - CDC DVBD - AGS Data Collection - Interview Discussion Guide - 12.14.23	Form and Instruction	Unchanged	Repair queued
Form 0920-24CA Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23	Form and Instruction	Unchanged	Repair queued
Form 0920-24CA Attachment 5 - CDC DVBD - AGS Data Collection - Focus Group Discussion Guide - 12.14.23	Form and Instruction	Unchanged	Available
Form 0920-24CA Attachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23	Form and Instruction	Unchanged	Repair queued
Form 0920-24CA [NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24CC) Interview Guide Tribal Health Care Providers (HCPs) and Tribal Leaders	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 (24CC) Focus Group Guide AI/AN Adults	Form and Instruction	Unchanged	Repair queued
Form 0920-1154-24CC Recruitment Materials - Focus Groups and Interviews - AI/AN Adults	Form	Unchanged	Available
Form 0920-1154-24CC [NCIPC] Screening Survey for focus groups and interviews	Form	Unchanged	Missing upstream
Focus Group Guide	Form and Instruction	Unchanged	Available
Focus Group Consent Form	Form and Instruction	Unchanged	Available
Focus Group Screener	Form and Instruction	Unchanged	Available
[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged	Repair queued
Form 0920-24BQ Att 3. CAN Focus Group Eligible Participant Screener rev	Form and Instruction	Unchanged	Available
Form 0920-24BQ Att 3. CAN Focus Group Eligible Participant Screener 11.21.23	Form and Instruction	Unchanged	Repair queued
Form 0920-24BQ Att 1. CAN Survey and Consent	Form and Instruction	Unchanged	Repair queued
Form 0920-24BQ [NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged	Available
Community Violence Focus Group Screening	Form and Instruction	Unchanged	Available
Community Violence Focus Group	Form and Instruction	Unchanged	Repair queued
Community Violence Survey and Consent	Form and Instruction	Unchanged	Repair queued
Firearm Injury and Death Focus Group Screening	Form and Instruction	Unchanged	Repair queued
Firearm Injury and Death Focus Group	Form and Instruction	Unchanged	Available
Firearm Injury and Death Survey and Consent	Form and Instruction	Unchanged	Available
[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Digital Ad	Form and Instruction	Unchanged	Available
Form 0920-1154 Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Broadcast Radio	Form and Instruction	Unchanged	Available
Form 0920-1154 Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Form and Instruction	Unchanged	Repair queued
Pace and non-Pace Evaluation Survey	Form and Instruction	Unchanged	Repair queued
Mini Lesson and Job Aid Survey	Form and Instruction	Unchanged	Repair queued
User Experience Survey	Form and Instruction	Unchanged	Available
Post Course Evaluation Survey	Form and Instruction	Unchanged	Available
Single Sign-Up Survey	Form and Instruction	Unchanged	Repair queued
[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Repair queued
Form 0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023	Form and Instruction	Unchanged	Available
Form 0920-1154-24AR [CSELS/DLS]CDC OneLab Network Formative Evaluation	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 MODERATOR INTERVIEW GUIDE In-Depth Interviews with Hispanic or Latina Women	Form and Instruction	Unchanged	Available
Form 0920-1154 CONSENT FORM In-Depth Interviews with Hispanic or Latina Women	Form	Unchanged	Available
Form 0920-1154 RECRUITMENT SCREENER In-Depth Interviews with Hispanic or Latina Women	Form and Instruction	Unchanged	Available
Form 0920-1154 [NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	Form and Instruction	Unchanged	Repair queued
AR Formative Evaluation Interview Guide	Form and Instruction	Unchanged	Repair queued
Technology Pre-check	Form and Instruction	Unchanged	Available
Recruitment Screener	Form and Instruction	Unchanged	Repair queued
[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project	Form and Instruction	Unchanged	Repair queued
Form 0920-23GU Attmt III- Focus Group Guide - English_Spanish	Form and Instruction	Unchanged	Repair queued
Form 0920-23GU [NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers	Form and Instruction	Unchanged	Repair queued
Training for Employers - Post-test	Form and Instruction	Unchanged	Repair queued
Training for Employers - Pre-test	Form and Instruction	Unchanged	Repair queued
Focus Group Guide for Employees - English/Spanish	Form and Instruction	Unchanged	Available
Focus Group Guide for Employers/Supervisors	Form and Instruction	Unchanged	Repair queued
[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged	Repair queued
Listening Sessions Guide for Providers Who Support People with Mental Health Disorders	Form and Instruction	Unchanged	Available
Listening Sessions Guide for Providers Who Support Minority Women	Form and Instruction	Unchanged	Repair queued
Listening Sessions Guide for Providers Who Support People with Learning Disabilities	Form and Instruction	Unchanged	Available
DSMES Provider Screener Script and Guidelines	Form and Instruction	Unchanged	Available
[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged	Repair queued
Respondent Consent Form and Participants Email	Form and Instruction	Unchanged	Repair queued
Online Survey	Form and Instruction	Unchanged	Available
Interview Guide	Form and Instruction	Unchanged	Available
Focus Group Moderator Guide	Form and Instruction	Unchanged	Available
Qualitative Eligibility Screener (Online)	Form and Instruction	Unchanged	Available
Qualitative Eligibility Screener (Phone)	Form and Instruction	Unchanged	Repair queued
Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Repair queued
Form 0920-23DA Attachment D_Focus Group Script	Form and Instruction	Unchanged	Repair queued
Form 0920-23DF Attachment C_Follow Up Survey Questions	Form and Instruction	Unchanged	Available
Form 0920- 23DF Attachment B_Immediate Post Exercise Survey Questions	Form and Instruction	Unchanged	Repair queued
Form 0920- 23DF [CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.)	Form and Instruction	Unchanged	Repair queued
Rapid Survey	Form and Instruction	Unchanged	Repair queued
Eligibility Screener for Rapid Survey	Form and Instruction	Unchanged	Available
Focus Group Moderator Guide	Form and Instruction	Unchanged	Available
[Additional] Eligible Participant Screener for Focus Group	Form and Instruction	Unchanged	Repair queued
Eligibility Screener for Focus Group	Form and Instruction	Unchanged	Available
[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Repair queued
Change Request form EO 14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-01	Repair queued
Change Request form EO 14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-01	Repair queued
ACEs_0920-1154_Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-25	Repair queued
ACEs_0920-1154_Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-25	Repair queued
60day.docx	Supplementary Document	Uploaded 2023-01-30	Repair queued
60day.docx	Supplementary Document	Uploaded 2023-01-30	Missing upstream
30day.2.docx	Supplementary Document	Uploaded 2023-01-30	Repair queued
30day.2.docx	Supplementary Document	Uploaded 2023-01-30	Repair queued
GenICRequestTemplate.docx	Supplementary Document	Uploaded 2019-12-05	Repair queued
GenICRequestTemplate.docx	Supplementary Document	Uploaded 2019-12-05	Missing upstream
60 day FRN.pdf	Supplementary Document	Uploaded 2019-12-05	Repair queued
60 day FRN.pdf	Supplementary Document	Uploaded 2019-12-05	Repair queued
SSB.docx	Supporting Statement B	Uploaded 2019-12-05	Repair queued
SSB.docx	Supporting Statement B	Uploaded 2019-12-05	Repair queued
SSA.2022.docx	Supporting Statement A	Uploaded 2023-01-30	Repair queued
SSA.2022.docx	Supporting Statement A	Uploaded 2023-01-30	Repair queued
AuthLegislation.doc	Supplementary Document	Uploaded 2016-10-20	Repair queued
AuthLegislation.doc	Supplementary Document	Uploaded 2016-10-20	Missing upstream

IC Document Collections

IC ID	Collection	Type	Status	Form
275745	[CPR] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey	Form	Unchanged	ASEAN PHEM WLP Survey
275745	[CPR] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey	Form	Unchanged
275557	[NCZEID] Lyme Disease Creative and Message Testing Focus Groups	Form	Unchanged	Lyme Disease Screener
275557	[NCZEID] Lyme Disease Creative and Message Testing Focus Groups	Form	Unchanged
275349	[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities	Form and Instruction	Unchanged	Interview Guide: Family/Close Friend (Follow-Up Interview)
275349	[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities	Form and Instruction	Unchanged	Interview Guide: Resident and Family/Close Friend (Paired Interview)
275349	[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities	Form and Instruction	Unchanged	DHQP Interview Screener
275349	[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities	Form and Instruction	Unchanged
275347	[NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged	Data_Interview
275347	[NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged	IVMS_Interview
275347	[NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged	MVC_Priorities_Interview
275347	[NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged
275346	[OPHDST] CDC ENGAGE Functionality Project	Form	Unchanged	Conversation guide
275346	[OPHDST] CDC ENGAGE Functionality Project	Form	Unchanged
275345	[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged	Intake Form
275345	[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged	Key Informant
275345	[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged	Request
275345	[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged
273877	[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged	Moderator Guide
273877	[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged	Eligibility Screener
273877	[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged	Screener
273877	[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Rapid Online Survey
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Focus Group Moderator Guide
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Eligibility Screener - Survey
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Eligible Participant Screener - Focus Group
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Eligibility Screener - Focus Group
273434	[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged
273021	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged	Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish
273021	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged	Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish
273021	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged	Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance
273021	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged	Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance
273021	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	Unchanged
272892	[NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers	Form	Unchanged	Sandwich Generation Consumer Focus Group Discussion Guide
272892	[NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers	Form	Unchanged	Sandwich Generation ConsumerScreener
272892	[NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers	Form	Unchanged	Sandwich Generation Consumer Survey
272892	[NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers	Form	Unchanged
272710	[NCZEID] Focus Groups with Consumers on Oropouche	Form	Unchanged	Focus Group Discussion Guide
272710	[NCZEID] Focus Groups with Consumers on Oropouche	Form	Unchanged	Focus Group Screener
272710	[NCZEID] Focus Groups with Consumers on Oropouche	Form	Unchanged
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Formative Evaluation for Transportation Safety Resource for Action Tool
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Semi-Structured Interview Guide
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Second Follow-up Email
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	First Follow-up Email
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Email Invitation
272172	[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified
272084	[OPHDST] Foundational User Interviews with the Public	Form and Instruction	Unchanged	Foundational Data Collection Interview Scripts (25AB)
272084	[OPHDST] Foundational User Interviews with the Public	Form and Instruction	Unchanged	Foundational Screener (25AB)
272084	[OPHDST] Foundational User Interviews with the Public	Form and Instruction	Unchanged
271878	[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction	Unchanged	Demo
271878	[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction	Unchanged	Focus Group Conversation Guide for Mine Managers and HS Professionals
271878	[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction	Unchanged	Focus Group Conversation Guide for Women Mine Workers
271878	[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction	Unchanged
271822	[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak	Form and Instruction	Unchanged	Online Survey Questionnaire (to be amended as appropriate following review of KII responses)
271822	[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak	Form and Instruction	Unchanged	Personal Protective Equipment Key Informant Interviews
271822	[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak	Form and Instruction	Unchanged
271778	[NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees	Form	Unchanged	Nail Salon Exposure Study Questionnaire Feedback Form
271778	[NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged	Nail Salon Exposure Study Questionnaire (24AA)
271778	[NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	ACEs Partner Interview Guide
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	ACEs Partner Interview Consent Form
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	ACEs Focus Group Consent Form
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	ACEs Focus Group Participant Screener - Revised 25MAR2025
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged	ACEs Survey and Consent - Revised 25MAR2025
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	Unchanged
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Other-Screenshots	Unchanged
270391	[NOISH] Customer Discovery Interviews with Five NIOSH Audiences	Instruction	Unchanged
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Travel Med Specialists - Interview Guide
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Travel Med Specialists - Consent Form
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Interview Recruitment Screener
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Focus Group Guide
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Consent Form
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged	Recruitment Screener
270207	[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	Unchanged
270185	[NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Feedback Survey for Community Counts Data Viz Tool
270185	[NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged
269870	[NCIPC] Caring Adults Perceptions on Teen Mental Health	Form	Unchanged	Screening Survey
269870	[NCIPC] Caring Adults Perceptions on Teen Mental Health	Form	Unchanged
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Form and Instruction	Unchanged	Adolescent Brainstorming Session Discussion Guide
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Form and Instruction	Unchanged	Adolescent Focus Group Discussion Guide
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Form and Instruction	Unchanged	Adolescent Interview Discussion Guide
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Form and Instruction	Unchanged	LGBTQ+ Teen Screening Survey
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Form and Instruction	Unchanged	Screening Survey and Parental Consent
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Instruction	Unchanged
269497	[NCIPC] Caring Adults Perceptions on Teen Mental Health	Form and Instruction	Unchanged	INTERVIEW DISCUSSION GUIDE
269497	[NCIPC] Caring Adults Perceptions on Teen Mental Health	Form and Instruction	Unchanged	ADULT MENTOR SCREENING SURVEY
269497	[NCIPC] Caring Adults Perceptions on Teen Mental Health	Instruction	Unchanged
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form	Unchanged	NIOSH Heat Stress Training Log
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form	Unchanged	Employee Focus Group Questions
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged	Employee Survey
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged	Script for POST-TRAINING INTERVIEW with OSH Managers and Trainers
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged	Script for Post-Preparation Interview with Osh Managers and Trainers (Prior to Training)
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged	Script for Initial Interview with OSH Managers and Trainers
269300	[NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research	Form and Instruction	Unchanged
269261	[NCIPC] Adoption Accelerator Social Network Analysis (Formative Research)	Form	Unchanged	Sheriffs’ Advice-Seeking Survey
269261	[NCIPC] Adoption Accelerator Social Network Analysis (Formative Research)	Form	Unchanged
268538	[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Form and Instruction	Unchanged	Activity Guide
268538	[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Form and Instruction	Unchanged	Parent and Child Screeners
268538	[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Form and Instruction	Unchanged
268538	[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Other-Consent	Unchanged
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Interview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Focus Group Guide for Consumers about Antimicrobial Resistance Concept Testing
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Interview Screener for Healthcare Providers
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Focus Group Screener for Consumers, Including Parents
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged
268340	[CPR] This is a T.E.S.T.	Form	Unchanged	Focus Group
268340	[CPR] This is a T.E.S.T.	Form	Unchanged	Follow- up Survey
268340	[CPR] This is a T.E.S.T.	Form	Unchanged	Initial Survey
268340	[CPR] This is a T.E.S.T.	Form	Unchanged
267631	[NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data	Form	Unchanged	NHSN’s REaLI Effort
267631	[NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data	Form	Unchanged
267350	[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form	Unchanged	Nail Salon Exposure Study Questionnaire Feedback Form (24FD)
267350	[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged	Nail Salon Exposure Study Questionnaire (24FD)
267350	[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form and Instruction	Unchanged
267344	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged	Leader Focus Groups
267344	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged	Staff Focus Groups
267344	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged	Pilot Evaluation POST-Implementation Survey
267344	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged	Pilot Evaluation Pre-Implementation Survey
267344	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Form	Unchanged
266946	In-Depth Interviews with Healthcare Professionals about C. Diff Materials	Form and Instruction	Unchanged	Antimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES)
266946	In-Depth Interviews with Healthcare Professionals about C. Diff Materials	Form and Instruction	Unchanged	Antimicrobial Resistance Communications and Media Support Services
266946	In-Depth Interviews with Healthcare Professionals about C. Diff Materials	Form and Instruction	Unchanged
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Retrospective Survey
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Post Workshop Survey
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Next Steps Tracker
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Participant Survey
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Facilitator Training Survey
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Baseline Survey
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	OHZDP Interest Intake Form
266547	[NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Survey on Antimicrobial Resistance Among National Policy Audiences
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Interview Guide for Consumers with Past Antimicrobial Resistant Infections on Antimicrobial Resistance
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	In-Depth Interview Screener for Consumers with Previous Antimicrobial-Resistant Infections
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Focus Group Guide for Caregivers about Antimicrobial Resistance
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Focus Group Guide for General Consumers about Antimicrobial Resistance
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Focus Group Screener for Consumers, Including Parents, and Caregivers
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Interview Guide for Medical Association about Antimicrobial Resistance
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Focus Group Guide for HCPs about Antimicrobial Resistance
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Focus Group Screener
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Form and Instruction	Unchanged	Focus Group Moderator Guide (24CX)
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged	Eligible Participant Screener for Focus Group (24CX)
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged	Screening/Eligibility Form for Focus Groups (24CX)
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Instruction	Unchanged
264920	[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	MESSAGES to be TESTED (24CU)
264920	[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Moderator or Interviewer Guide (24CU)
264920	[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Eligible Participant Screener (24CU)
264920	[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form	Unchanged	Screening/Eligibility Form for Interviews/Focus Groups (24CU)
264920	[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes	Form	Unchanged
264849	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form and Instruction	Unchanged	Focus Group Moderator Guide (24CP)
264849	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form	Unchanged	Eligible Participant Screener for Focus Group (24CP)
264849	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form	Unchanged	Screening/Eligibility Form for Focus Groups
264849	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form	Unchanged
264849	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Other-Consent	Unchanged
264809	(NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring	Form and Instruction	Unchanged	Antifungal TDM Focus Group Guide
264809	(NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring	Form and Instruction	Unchanged	Antifungal TDM Focus Group Screener
264809	(NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring	Form and Instruction	Unchanged
264581	[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Attachment 6 - CDC DVBD - AGS Data Collection - Interview Discussion Guide - 12.14.23
264581	[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23
264581	[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Attachment 5 - CDC DVBD - AGS Data Collection - Focus Group Discussion Guide - 12.14.23
264581	[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Attachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23
264581	[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged
264563	[NCIPC] Screening Survey for focus groups and interviews	Form and Instruction	Unchanged	Interview Guide Tribal Health Care Providers (HCPs) and Tribal Leaders
264563	[NCIPC] Screening Survey for focus groups and interviews	Form and Instruction	Unchanged	Focus Group Guide AI/AN Adults
264563	[NCIPC] Screening Survey for focus groups and interviews	Form	Unchanged	Recruitment Materials - Focus Groups and Interviews - AI/AN Adults
264563	[NCIPC] Screening Survey for focus groups and interviews	Form	Unchanged
264563	[NCIPC] Screening Survey for focus groups and interviews	Instruction	Unchanged
264149	[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged	Focus Group Guide
264149	[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged	Focus Group Consent Form
264149	[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged	Focus Group Screener
264149	[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged
264017	[NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged	Att 3. CAN Focus Group Eligible Participant Screener rev
264017	[NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged	Att 3. CAN Focus Group Eligible Participant Screener 11.21.23
264017	[NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged	Att 1. CAN Survey and Consent
264017	[NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Community Violence Focus Group Screening
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Community Violence Focus Group
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Community Violence Survey and Consent
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Firearm Injury and Death Focus Group Screening
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Firearm Injury and Death Focus Group
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Firearm Injury and Death Survey and Consent
263776	[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged
263672	Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Form and Instruction	Unchanged	Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Digital Ad
263672	Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Form and Instruction	Unchanged	Stop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Broadcast Radio
263672	Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Form and Instruction	Unchanged
263672	Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Other-Screenshots - Broadcast Radio	Unchanged
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Pace and non-Pace Evaluation Survey
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Mini Lesson and Job Aid Survey
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	User Experience Survey
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Post Course Evaluation Survey
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Single Sign-Up Survey
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged
263194	[CSELS/DLS]CDC OneLab Network Formative Evaluation	Form and Instruction	Unchanged	04_Attachment 1_OneLab Network Survey_10-26-2023
263194	[CSELS/DLS]CDC OneLab Network Formative Evaluation	Form and Instruction	Unchanged
261872	Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged	Feedback Survey for Community Counts Data Viz Tool
261872	Feedback Survey for Community Counts Data Viz Tool	Form and Instruction	Unchanged
261557	[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	Form and Instruction	Unchanged	MODERATOR INTERVIEW GUIDE In-Depth Interviews with Hispanic or Latina Women
261557	[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	Form	Unchanged	CONSENT FORM In-Depth Interviews with Hispanic or Latina Women
261557	[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	Form and Instruction	Unchanged	RECRUITMENT SCREENER In-Depth Interviews with Hispanic or Latina Women
261557	[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	Form and Instruction	Unchanged
261493	[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project	Form and Instruction	Unchanged	AR Formative Evaluation Interview Guide
261493	[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project	Form and Instruction	Unchanged	Technology Pre-check
261493	[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project	Form and Instruction	Unchanged	Recruitment Screener
261493	[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project	Form and Instruction	Unchanged
261060	[NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers	Form and Instruction	Unchanged	Attmt III- Focus Group Guide - English_Spanish
261060	[NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers	Form and Instruction	Unchanged
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged	Training for Employers - Post-test
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged	Training for Employers - Pre-test
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged	Focus Group Guide for Employees - English/Spanish
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged	Focus Group Guide for Employers/Supervisors
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Form and Instruction	Unchanged
261054	[NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations	Other-Consent	Unchanged
260016	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged	Listening Sessions Guide for Providers Who Support People with Mental Health Disorders
260016	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged	Listening Sessions Guide for Providers Who Support Minority Women
260016	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged	Listening Sessions Guide for Providers Who Support People with Learning Disabilities
260016	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged	DSMES Provider Screener Script and Guidelines
260016	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)	Form and Instruction	Unchanged
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Respondent Consent Form and Participants Email
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Online Survey
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Interview Guide
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Focus Group Moderator Guide
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Qualitative Eligibility Screener (Online)
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged	Qualitative Eligibility Screener (Phone)
259194	Formative Research for Spanish-Language Drug Overdose Messages	Form and Instruction	Unchanged
259194	Formative Research for Spanish-Language Drug Overdose Messages	Instruction	Unchanged
259152	[CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.)	Form and Instruction	Unchanged	Attachment D_Focus Group Script
259152	[CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.)	Form and Instruction	Unchanged	Attachment C_Follow Up Survey Questions
259152	[CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.)	Form and Instruction	Unchanged	Attachment B_Immediate Post Exercise Survey Questions
259152	[CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.)	Form and Instruction	Unchanged
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Rapid Survey
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Eligibility Screener for Rapid Survey
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Focus Group Moderator Guide
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	[Additional] Eligible Participant Screener for Focus Group
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Eligibility Screener for Focus Group
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged
259053	[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Other-Screenshots of the Eligibility Screener for the Rapid Surv	Unchanged

ICR Details

OMB Control No: 0920-1154	ICR Reference No: 202507-0920-001
Status: Historical Active	Previous ICR Reference No: 202506-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0040
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: 07/03/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/01/2025
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

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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 current EOs and other minor changes. This one is for "Formative Evaluation for Transportation Safety Resource for Action Tool"

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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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

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Number of Information Collection (IC) in this ICR: 55

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] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey	0920-25-0125	ASEAN PHEM WLP Survey
[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	n/a, n/a, n/a, n/a	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 about Infection Prevention and Control Practices in Long-Term Care Facilities	n/a, n/a, n/a	DHQP Interview Screener ,   Interview Guide: Resident and Family/Close Friend (Paired Interview) ,   Interview Guide: Family/Close Friend (Follow-Up Interview)
[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	0920-24HY	Screening Survey
[NCIPC] Caring Adults Perceptions on Teen Mental Health	0920-1154 (24HL), 0920-1154 (2HL)	ADULT MENTOR SCREENING SURVEY ,   INTERVIEW DISCUSSION GUIDE
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	n/a, n/a, n/a, n/a, 0920-25-0040	Email Invitation ,   First Follow-up Email ,   Second Follow-up Email ,   Semi-Structured Interview Guide ,   Formative Evaluation for Transportation Safety Resource for Action Tool
[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
[NCZEID] Lyme Disease Creative and Message Testing Focus Groups	0920-25-0124	Lyme Disease Screener
[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] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	0920-25-0059, 0920-25-0059, 0920-25-0059	MVC_Priorities_Interview ,   IVMS_Interview ,   Data_Interview
[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 Formative Evaluation - Key Informant Semi-Structured Interviews	0920-25-0094, 0920-25-0094, 0920-25-0094	Request ,   Key Informant ,   Intake Form
[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] CDC ENGAGE Functionality Project	0920-25-0088	Conversation guide
[OPHDST] Foundational User Interviews with the Public	0920-1154, 0920-1154	Foundational Screener (25AB) ,   Foundational Data Collection Interview Scripts (25AB)

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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:

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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

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/01/2025

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