[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies

[OS] CDC/ATSDR Formative Research and Tool Development

Documents and Forms

Document Name Document Type
[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Form
[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Form
Pilot Evaluation Pre-Implementation Survey AttA-SurveyPrePost_cleanv2.docx Form
Pilot Evaluation Pre-Implementation Survey AttA-SurveyPrePost_cleanv2.docx Form
Pilot Evaluation POST-Implementation Survey AttA-SurveyPrePost_cleanv2.docx Form
Pilot Evaluation POST-Implementation Survey AttA-SurveyPrePost_cleanv2.docx Form
Staff Focus Groups AttC-FocusGroup-Sta - clean.docx Form
Staff Focus Groups AttC-FocusGroup-Sta - clean.docx Form
Leader Focus Groups AttB-FocusGroup-lea - clean.docx Form
Leader Focus Groups AttB-FocusGroup-lea - clean.docx Form
ORR-0920-1154-GenIRequestTemplate-BuildingResilience.docx GenIC Request IC Document
ORR-0920-1154-GenIRequestTemplate-BuildingResilience.docx GenIC Request IC Document
ORR-SSA-1154-BuildingResilience (1).docx SSA IC Document
ORR-SSA-1154-BuildingResilience (1).docx SSA IC Document
ORR-SSB-1154-BuildingResilience.docx SSB IC Document
ORR-SSB-1154-BuildingResilience.docx SSB IC Document
Change Request Memo - EO14168 Template- GenIC-0920-1154 - ORR .docx Change Request Justification IC Document
Change Request Memo - EO14168 Template- GenIC-0920-1154 - ORR .docx Change Request Justification IC Document

Information Collection (IC) Details

IC Title:	[CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies	Agency IC Tracking Number:	0920-25-0031

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	n/a	Pilot Evaluation Pre-Implementation Survey	AttA-SurveyPrePost_cleanv2.docx	Yes	Yes	Fillable Fileable
Form	n/a	Pilot Evaluation POST-Implementation Survey	AttA-SurveyPrePost_cleanv2.docx	Yes	Yes	Fillable Fileable
Form	n/a	Staff Focus Groups	AttC-FocusGroup-Sta - clean.docx	Yes	Yes	Fillable Fileable
Form	n/a	Leader Focus Groups	AttB-FocusGroup-lea - clean.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,084	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,084	1,084
Annual IC Time Burden (Hours)	334	334
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request	ORR-0920-1154-GenIRequestTemplate-BuildingResilience.docx	04/30/2024
SSA	ORR-SSA-1154-BuildingResilience (1).docx	04/30/2024
SSB	ORR-SSB-1154-BuildingResilience.docx	04/30/2024
Change Request Justification	Change Request Memo - EO14168 Template- GenIC-0920-1154 - ORR .docx	06/17/2025

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