[OS] CDC/ATSDR Formative Research and Tool Development

Forms and Documents

Document	Type	Status	Availability
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 [NCZEID] Lyme Disease Creative and Message Testing Focus Groups	Form	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 [NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot	Form	Unchanged	Repair queued
Form 0920-25-0088 [OPHDST] CDC ENGAGE Functionality Project	Form	Unchanged	Repair queued
Form 0920-25-0094 [OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged	Missing upstream
Form 25-0003 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form	Unchanged	Repair queued
Form 0920-1154 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 [NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Form and Instruction	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 [NCZEID] Focus Groups with Consumers on Oropouche	Form	Unchanged	Repair queued
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction	Modified	Repair queued
Form 0920-1154 [OPHDST] Foundational User Interviews with the Public	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
[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 [NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees	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 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists	Form	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 [NCIPC] Caring Adults Perceptions on Teen Mental Health	Form	Unchanged	Repair queued
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 [NCIPC] Adoption Accelerator Social Network Analysis (Formative Research)	Form	Unchanged	Repair queued
[NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged	Repair queued
Form 0920-24GC [CPR] This is a T.E.S.T.	Form	Unchanged	Repair queued
Form 092061154 [NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data	Form	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
[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 In-Depth Interviews with Healthcare Professionals about C. Diff Materials	Form and Instruction	Unchanged	Repair queued
Form 0920-24EH [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process	Form	Unchanged	Repair queued
Form 0920-24DM [NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged	Repair queued
Form 0920-1154 [NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged	Repair queued
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 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Form	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 [NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome	Form and Instruction	Unchanged	Repair queued
Form 0920-1154-24CC [NCIPC] Screening Survey for focus groups and interviews	Form	Unchanged	Repair queued
[NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses	Form and Instruction	Unchanged	Repair queued
Form 0920-24BQ [NICPC] Child Abuse and Neglect Prevention Message Development	Form and Instruction	Unchanged	Available
[NCIPC] Formative Research for Firearm Violence and Community Violence Messaging	Form and Instruction	Unchanged	Repair queued
Form 0920-1154 Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys)	Form and Instruction	Unchanged	Repair queued
[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged	Repair queued
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 [NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases	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 [NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers	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
[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
Formative Research for Spanish-Language Drug Overdose Messages	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
[NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes	Form and Instruction	Unchanged	Missing upstream
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
60day.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
60 day FRN.pdf	Supplementary Document	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
AuthLegislation.doc	Supplementary Document	Uploaded 2016-10-20	Repair queued

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
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
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
275345	[OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews	Form	Unchanged
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
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
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
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
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 and Instruction	Unchanged
270987	[NCIPC] Adverse Childhood Experiences Prevention Message Development	Form and Instruction	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
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
269522	[NCIPC] Adolescent Mental Health Journey Mapping Project	Instruction	Unchanged
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 and Instruction	Unchanged
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
268471	Creative Concept Testing on Antimicrobial Resistance	Form and Instruction	Unchanged
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
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
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
265912	[NCZEID] Formative Communications Assessment on Antimicrobial Resistance	Form	Unchanged
265153	[NCEZID] Harmful Algal Blooms Communication Evaluation	Form	Unchanged
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	Unchanged
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
264563	[NCIPC] Screening Survey for focus groups and interviews	Form	Unchanged
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
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
263317	[OLSS] CDC OneLab REACH Formative Evaluation	Form and Instruction	Unchanged
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
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
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
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
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

ICR Details

OMB Control No: 0920-1154	ICR Reference No: 202507-0920-001
Status: Received in OIRA	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	Date Submitted to OIRA: 07/01/2025

	Requested	Previously Approved
Expiration Date	03/31/2026	03/31/2026
Responses	75,000	75,000
Time Burden (Hours)	60,000	60,000
Cost Burden (Dollars)	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	0920-1154 (24HL), 0920-1154 (2HL)	ADULT MENTOR SCREENING SURVEY ,   INTERVIEW DISCUSSION GUIDE
[NCIPC] Caring Adults Perceptions on Teen Mental Health	0920-24HY	Screening Survey
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	n/a, n/a, n/a, n/a, 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 Request	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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