Information Collection Request

[OS] CDC/ATSDR Formative Research and Tool Development

ICR 202507-0920-010 · OMB 0920-1154 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1154 Survey - Frontline personnel of hospitals and health systems Form and Instruction New Repair queued
Form 0920-1154 Discussion Guide - Frontline personnel of hospitals and health systems Form and Instruction New Repair queued
Form 0920-1154 Survey - Leadership of hospitals and health systems Form and Instruction New Repair queued
Form 0920-1154 Discussion Guide - Leadership of hospitals and health systems Form and Instruction New Repair queued
Form 0920-1154 Teen Pulse Survey Form and Instruction New Repair queued
Form 0920-1154 Wave 3 - Young Adult Survey Form and Instruction New Repair queued
Form 0920-1154 Wave 3 - Parent Survey Form and Instruction New Repair queued
PACE and non PACE Evaluation Survey Form and Instruction New Repair queued
Mini Lesson Job Aid Surveys Form and Instruction New Repair queued
User Experience Survey Form and Instruction New Repair queued
Post Course Evaluation Survey Form and Instruction New Repair queued
Single Sign-up Survey Form and Instruction New Repair queued
Interview Guide Form and Instruction New Repair queued
Consent Form and Instruction New Repair queued
Screener Form and Instruction New Repair queued
Form 0920-1154 TITLE 42—Authorizing Legislation Form and Instruction New Repair queued
Form 0920-1154 Participant Feedback Survey Form and Instruction New Repair queued
Form 0920-1154 Hotwash Facilitation Guide Form and Instruction New Repair queued
Form 0920-25-0136 HSR Discussion Guide Form New Repair queued
Form 0920-25-0125 ASEAN PHEM WLP Survey Form Unchanged Available
Form 0920-25-0124 Lyme Disease Screener 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
Form 0920-25-0059 Data_Interview Form Unchanged Available
Form 0920-25-0059 IVMS_Interview Form Unchanged Repair queued
Form 0920-25-0059 MVC_Priorities_Interview Form Unchanged Available
Form 0920-25-0088 Conversation guide Form Unchanged Available
Form 0920-25-0094 Intake Form Form Unchanged Repair queued
Form 0920-25-0094 Key Informant Form Unchanged Available
Form 0920-25-0094 Request Form Unchanged Available
Form 25-0003 Moderator Guide Form Unchanged Available
Form 25-0003 Eligibility Screener Form Unchanged Available
Form 25-0003 Screener Form Unchanged Available
Form 0920-25-0046 Rapid Online Survey Form 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 0920-25-0046 Eligible Participant Screener - Focus Group Form Unchanged Available
Form 0920-1154 Eligibility Screener - Focus Group Form and Instruction Unchanged Available
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 0920-25BU Sandwich Generation Consumer Focus Group Discussion Guide Form Unchanged Available
Form 0920-25BU Sandwich Generation ConsumerScreener Form Unchanged Available
Form 0920-25BU Sandwich Generation Consumer Survey Form Unchanged Available
Form 0920-25BP Focus Group Discussion Guide Form Unchanged Available
Form 0920-25BP Focus Group Screener Form Unchanged Available
Form 0920-25-0040 Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction Unchanged Available
Semi-Structured Interview Guide Form and Instruction Unchanged Repair queued
Second Follow-up Email Form and Instruction Unchanged Repair queued
First Follow-up Email Form and Instruction Unchanged Available
Email Invitation Form and Instruction Unchanged Repair queued
Form 0920-1154 Foundational Data Collection Interview Scripts (25AB) Form and Instruction Unchanged Available
Form 0920-1154 Foundational Screener (25AB) Form and Instruction Unchanged Available
Demo Form and Instruction Unchanged Repair queued
Focus Group Conversation Guide for Mine Managers and HS Professionals Form and Instruction Unchanged Available
Focus Group Conversation Guide for 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 Available
Form 0920-1154 (24AA) Nail Salon Exposure Study Questionnaire Feedback Form Form Unchanged Available
Form 0920-1154 Nail Salon Exposure Study Questionnaire (24AA) Form and Instruction Unchanged Available
Form 0920-1154 (24IP) ACEs Partner Interview Guide Form and Instruction Unchanged Available
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 Repair queued
Form 0920-1154 ACEs Survey and Consent - Revised 25MAR2025 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 Available
Form 0920-24ID Interview Recruitment Screener Form Unchanged Repair queued
Form 0920-24ID Focus Group Guide Form Unchanged Repair queued
Form 0920-24ID Consent Form Form Unchanged Repair queued
Form 0920-24ID Recruitment Screener Form Unchanged Available
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool Form and Instruction Unchanged Available
Form 0920-24HY Screening Survey Form Unchanged Available
Adolescent Brainstorming Session Discussion Guide Form and Instruction Unchanged Repair queued
Adolescent Focus Group Discussion Guide Form and Instruction Unchanged Repair queued
Adolescent Interview Discussion Guide Form and Instruction Unchanged Available
LGBTQ+ Teen Screening Survey Form and Instruction Unchanged Available
Screening Survey and Parental Consent Form and Instruction Unchanged Repair queued
Form 0920-1154 (2HL) INTERVIEW DISCUSSION GUIDE Form and Instruction Unchanged Available
Form 0920-1154 (24HL) ADULT MENTOR SCREENING SURVEY Form and Instruction Unchanged Available
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 Available
Form 0920-1154 Script for Initial Interview with OSH Managers and Trainers Form and Instruction Unchanged Repair queued
Form 0920-24GZ Sheriffs’ Advice-Seeking Survey Form Unchanged Available
Activity Guide Form and Instruction Unchanged Repair queued
Parent and Child Screeners Form and Instruction Unchanged Available
Form 0920-1154 Interview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing Form and Instruction Unchanged Repair queued
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 0920-24GC Focus Group Form Unchanged Available
Form 0920-24GC Follow- up Survey Form Unchanged Available
Form 0920-24GC Initial Survey Form Unchanged Available
Form 092061154 NHSN’s REaLI Effort Form Unchanged Available
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
Leader Focus Groups Form Unchanged Available
Staff Focus Groups Form Unchanged Repair queued
Pilot Evaluation POST-Implementation Survey Form Unchanged Available
Pilot Evaluation Pre-Implementation Survey Form Unchanged Available
Form 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES) Form and Instruction Unchanged Available
Form 0920-1154-24ES Antimicrobial Resistance Communications and Media Support Services Form and Instruction Unchanged Available
Form 0920-24EH OHZDP Retrospective Survey Form Unchanged Available
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 Available
Form 0920-24EH OHZDP Facilitator Training Survey Form Unchanged Available
Form 0920-24EH OHZDP Baseline Survey Form Unchanged Repair queued
Form 0920-24EH OHZDP Interest Intake Form Form Unchanged Available
Form 0920-24DM Survey on Antimicrobial Resistance Among National Policy Audiences Form Unchanged Available
Form 0920-24DM Interview Guide for Consumers with Past Antimicrobial Resistant Infections on Antimicrobial Resistance Form Unchanged Available
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 Available
Form 0920-24DM Focus Group Guide for General Consumers about Antimicrobial Resistance Form Unchanged Available
Form 0920-24DM Focus Group Screener for Consumers, Including Parents, and Caregivers Form Unchanged Available
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 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 Repair queued
Form 0920-1154 MESSAGES to be TESTED (24CU) Form and Instruction Unchanged Available
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 Focus Group Moderator Guide (24CP) Form and Instruction Unchanged Available
Form 0920-1154 Eligible Participant Screener for Focus Group (24CP) Form Unchanged Available
Form 0920-1154 Screening/Eligibility Form for Focus Groups Form Unchanged Available
Antifungal TDM Focus Group Guide Form and Instruction Unchanged Repair queued
Antifungal TDM Focus Group Screener 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 Available
Form 0920-24CA Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23 Form and Instruction Unchanged Available
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 Available
Form 0920-1154 (24CC) Interview Guide Tribal Health Care Providers (HCPs) and Tribal Leaders Form and Instruction Unchanged Available
Form 0920-1154 (24CC) Focus Group Guide AI/AN Adults Form and Instruction Unchanged Available
Form 0920-1154-24CC Recruitment Materials - Focus Groups and Interviews - AI/AN Adults Form Unchanged Available
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
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 Available
Form 0920-24BQ Att 1. CAN Survey and Consent Form and Instruction Unchanged Repair queued
Community Violence Focus Group Screening Form and Instruction Unchanged Available
Community Violence Focus Group Form and Instruction Unchanged Available
Community Violence Survey and Consent Form and Instruction Unchanged Repair queued
Firearm Injury and Death Focus Group Screening Form and Instruction Unchanged Available
Firearm Injury and Death Focus Group Form and Instruction Unchanged Available
Firearm Injury and Death Survey and Consent Form and Instruction Unchanged Available
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
Pace and non-Pace Evaluation Survey Form and Instruction Modified Available
Mini Lesson and Job Aid Survey Form and Instruction Modified Available
User Experience Survey Form and Instruction Modified Repair queued
Post Course Evaluation Survey Form and Instruction Modified Available
Form 0920-1154 Single Sign-Up Survey - Revised 15JUL2025 Form and Instruction Modified Available
Form 0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023 Form and Instruction Unchanged Repair queued
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool Form and Instruction Unchanged Available
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
AR Formative Evaluation Interview Guide Form and Instruction Unchanged Available
Technology Pre-check Form and Instruction Unchanged Available
Recruitment Screener Form and Instruction Unchanged Available
Form 0920-23GU Attmt III- Focus Group Guide - English_Spanish Form and Instruction Unchanged Available
Training for Employers - Post-test Form and Instruction Unchanged Repair queued
Training for Employers - Pre-test Form and Instruction Unchanged Available
Focus Group Guide for Employees - English/Spanish Form and Instruction Unchanged Available
Focus Group Guide for Employers/Supervisors Form and Instruction Unchanged Available
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 Available
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
Respondent Consent Form and Participants Email Form and Instruction Unchanged Repair queued
Online Survey Form and Instruction Unchanged Repair queued
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 Available
Form 0920-23DA Attachment D_Focus Group Script Form and Instruction Unchanged Available
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 Available
Rapid Survey Form and Instruction Unchanged Available
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 Available
Eligibility Screener for Focus Group Form and Instruction Unchanged Available
Change Request Memo - EO14168 Template - OneLab REACH_3.18.25_final.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-15 Available
Change Request form EO 14168_WIM.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-03 Available
Change Request form EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-01 Available
ACEs_0920-1154_Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-25 Available
60day.docx Supplementary Document Uploaded 2023-01-30 Repair queued
30day.2.docx Supplementary Document Uploaded 2023-01-30 Available
GenICRequestTemplate.docx Supplementary Document Uploaded 2019-12-05 Repair queued
60 day FRN.pdf Supplementary Document Uploaded 2019-12-05 Available
SSB.docx Supporting Statement B Uploaded 2019-12-05 Available
SSA.2022.docx Supporting Statement A Uploaded 2023-01-30 Available
AuthLegislation.doc Supplementary Document Uploaded 2016-10-20 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
278697 [NCEZID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community Form and Instruction NewSurvey - Frontline personnel of hospitals and health systems
278697 [NCEZID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community Form and Instruction NewDiscussion Guide - Frontline personnel of hospitals and health systems
278697 [NCEZID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community Form and Instruction NewSurvey - Leadership of hospitals and health systems
278697 [NCEZID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community Form and Instruction NewDiscussion Guide - Leadership of hospitals and health systems
278573 [NCCDPHP] Health Surveys of Teens, Young Adults, and Parents of Children and Adolescents Form and Instruction NewTeen Pulse Survey
278573 [NCCDPHP] Health Surveys of Teens, Young Adults, and Parents of Children and Adolescents Form and Instruction NewWave 3 - Young Adult Survey
278573 [NCCDPHP] Health Surveys of Teens, Young Adults, and Parents of Children and Adolescents Form and Instruction NewWave 3 - Parent Survey
277061 [OLSS] CDC Onelab REACH Formative Evaluation Form and Instruction NewPACE and non PACE Evaluation Survey
277061 [OLSS] CDC Onelab REACH Formative Evaluation Form and Instruction NewMini Lesson Job Aid Surveys
277061 [OLSS] CDC Onelab REACH Formative Evaluation Form and Instruction NewUser Experience Survey
277061 [OLSS] CDC Onelab REACH Formative Evaluation Form and Instruction NewPost Course Evaluation Survey
277061 [OLSS] CDC Onelab REACH Formative Evaluation Form and Instruction NewSingle Sign-up Survey
276798 [NCEZID] In-Depth Interviews with Young Adults About Emergency Response Communication Form and Instruction NewInterview Guide
276798 [NCEZID] In-Depth Interviews with Young Adults About Emergency Response Communication Form and Instruction NewConsent
276798 [NCEZID] In-Depth Interviews with Young Adults About Emergency Response Communication Form and Instruction NewScreener
276755 [ORR] Congregate Settings Infectious Disease Outbreak Tabletop Exercise (TTX) Hotwash and Survey Form and Instruction NewTITLE 42—Authorizing Legislation
276755 [ORR] Congregate Settings Infectious Disease Outbreak Tabletop Exercise (TTX) Hotwash and Survey Form and Instruction NewParticipant Feedback Survey
276755 [ORR] Congregate Settings Infectious Disease Outbreak Tabletop Exercise (TTX) Hotwash and Survey Form and Instruction NewHotwash Facilitation Guide
276651 [NCZEID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community Form NewHSR Discussion Guide
275745 [CPR] Association of Southeast Asia Nations (ASEAN) Public Health Emergency Management (PHEM) Emerging Leaders Program (ELP) Survey Form UnchangedASEAN PHEM WLP Survey
275557 [NCZEID] Lyme Disease Creative and Message Testing Focus Groups Form UnchangedLyme Disease Screener
275349 [NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities Form and Instruction UnchangedInterview 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 UnchangedInterview 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 UnchangedDHQP Interview Screener
275347 [NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot Form UnchangedData_Interview
275347 [NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot Form UnchangedIVMS_Interview
275347 [NIOSH] Formative Needs Assessment for Regional Worker Health Monitoring in a Rural Oil and Gas Basin: A Pilot Form UnchangedMVC_Priorities_Interview
275346 [OPHDST] CDC ENGAGE Functionality Project Form UnchangedConversation guide
275345 [OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews Form UnchangedIntake Form
275345 [OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews Form UnchangedKey Informant
275345 [OLSS] CDC OneLab Formative Evaluation - Key Informant Semi-Structured Interviews Form UnchangedRequest
273877 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation Form UnchangedModerator Guide
273877 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation Form UnchangedEligibility Screener
273877 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation Form UnchangedScreener
273434 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Form UnchangedRapid Online Survey
273434 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Form and Instruction UnchangedFocus Group Moderator Guide
273434 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Form and Instruction UnchangedEligibility Screener - Survey
273434 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Form UnchangedEligible Participant Screener - Focus Group
273434 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention Form and Instruction UnchangedEligibility Screener - Focus Group
273021 [NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance Form and Instruction UnchangedNon-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 UnchangedPhysician - 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 UnchangedNon-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 UnchangedPhysician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance
272892 [NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers Form UnchangedSandwich Generation Consumer Focus Group Discussion Guide
272892 [NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers Form UnchangedSandwich Generation ConsumerScreener
272892 [NCZEID] Formative Evaluation and Message Testing of Antimicrobial Resistance Among Sandwich Generation Consumers Form UnchangedSandwich Generation Consumer Survey
272710 [NCZEID] Focus Groups with Consumers on Oropouche Form UnchangedFocus Group Discussion Guide
272710 [NCZEID] Focus Groups with Consumers on Oropouche Form UnchangedFocus Group Screener
272172 [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction UnchangedFormative Evaluation for Transportation Safety Resource for Action Tool
272172 [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction UnchangedSemi-Structured Interview Guide
272172 [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction UnchangedSecond Follow-up Email
272172 [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction UnchangedFirst Follow-up Email
272172 [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool Form and Instruction UnchangedEmail Invitation
272084 [OPHDST] Foundational User Interviews with the Public Form and Instruction UnchangedFoundational Data Collection Interview Scripts (25AB)
272084 [OPHDST] Foundational User Interviews with the Public Form and Instruction UnchangedFoundational Screener (25AB)
271878 [NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers Form and Instruction UnchangedDemo
271878 [NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers Form and Instruction UnchangedFocus 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 UnchangedFocus Group Conversation Guide for Women Mine Workers
271822 [CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak Form and Instruction UnchangedOnline 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 UnchangedPersonal Protective Equipment Key Informant Interviews
271778 [NIOSH] Assessment of Task-Based Exposures That May Affect Reproductive Health in Nail Salon Employees Form UnchangedNail 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 UnchangedNail Salon Exposure Study Questionnaire (24AA)
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Form and Instruction UnchangedACEs Partner Interview Guide
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Form and Instruction UnchangedACEs Partner Interview Consent Form
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Form and Instruction UnchangedACEs Focus Group Consent Form
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Form and Instruction UnchangedACEs Focus Group Participant Screener - Revised 25MAR2025
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Other-Screenshots Unchanged
270987 [NCIPC] Adverse Childhood Experiences Prevention Message Development Form and Instruction UnchangedACEs Survey and Consent - Revised 25MAR2025
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 UnchangedTravel Med Specialists - Interview Guide
270207 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Form UnchangedTravel Med Specialists - Consent Form
270207 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Form UnchangedInterview Recruitment Screener
270207 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Form UnchangedFocus Group Guide
270207 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Form UnchangedConsent Form
270207 [NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists Form UnchangedRecruitment Screener
270185 [NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool Form and Instruction UnchangedFeedback Survey for Community Counts Data Viz Tool
269870 [NCIPC] Caring Adults Perceptions on Teen Mental Health Form UnchangedScreening Survey
269522 [NCIPC] Adolescent Mental Health Journey Mapping Project Form and Instruction UnchangedAdolescent Brainstorming Session Discussion Guide
269522 [NCIPC] Adolescent Mental Health Journey Mapping Project Form and Instruction UnchangedAdolescent Focus Group Discussion Guide
269522 [NCIPC] Adolescent Mental Health Journey Mapping Project Form and Instruction UnchangedAdolescent Interview Discussion Guide
269522 [NCIPC] Adolescent Mental Health Journey Mapping Project Form and Instruction UnchangedLGBTQ+ Teen Screening Survey
269522 [NCIPC] Adolescent Mental Health Journey Mapping Project Form and Instruction UnchangedScreening 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 UnchangedINTERVIEW DISCUSSION GUIDE
269497 [NCIPC] Caring Adults Perceptions on Teen Mental Health Form and Instruction UnchangedADULT 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 UnchangedNIOSH Heat Stress Training Log
269300 [NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research Form UnchangedEmployee Focus Group Questions
269300 [NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research Form and Instruction UnchangedEmployee Survey
269300 [NIOSH] Keeping Cool: Evaluating NIOSH's Heat Stress Training Module to Inform Resource Development and Research Form and Instruction UnchangedScript 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 UnchangedScript 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 UnchangedScript for Initial Interview with OSH Managers and Trainers
269261 [NCIPC] Adoption Accelerator Social Network Analysis (Formative Research) Form UnchangedSheriffs’ Advice-Seeking Survey
268538 [NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages Form and Instruction UnchangedActivity Guide
268538 [NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages Other-Consent Unchanged
268538 [NCIPC] Youth Audience Message Testing of Substance Use Prevention Messages Form and Instruction UnchangedParent and Child Screeners
268471 Creative Concept Testing on Antimicrobial Resistance Form and Instruction UnchangedInterview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing
268471 Creative Concept Testing on Antimicrobial Resistance Form and Instruction UnchangedFocus Group Guide for Consumers about Antimicrobial Resistance Concept Testing
268471 Creative Concept Testing on Antimicrobial Resistance Form and Instruction UnchangedInterview Screener for Healthcare Providers
268471 Creative Concept Testing on Antimicrobial Resistance Form and Instruction UnchangedFocus Group Screener for Consumers, Including Parents
268340 [CPR] This is a T.E.S.T. Form UnchangedFocus Group
268340 [CPR] This is a T.E.S.T. Form UnchangedFollow- up Survey
268340 [CPR] This is a T.E.S.T. Form UnchangedInitial Survey
267631 [NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data Form UnchangedNHSN’s REaLI Effort
267350 [NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees Form UnchangedNail 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 UnchangedNail Salon Exposure Study Questionnaire (24FD)
267344 [CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Form UnchangedLeader Focus Groups
267344 [CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Form UnchangedStaff Focus Groups
267344 [CPR] Pilots Evaluation of Interventions for Building Resilience for State and Local Health Department Staff Responding to Public Health Emergencies Form UnchangedPilot 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 UnchangedPilot Evaluation Pre-Implementation Survey
266946 In-Depth Interviews with Healthcare Professionals about C. Diff Materials Form and Instruction UnchangedAntimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES)
266946 In-Depth Interviews with Healthcare Professionals about C. Diff Materials Form and Instruction UnchangedAntimicrobial Resistance Communications and Media Support Services
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Retrospective Survey
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Post Workshop Survey
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Next Steps Tracker
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Participant Survey
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Facilitator Training Survey
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Baseline Survey
266547 [NCZEID] CDC One Health Zoonotic Disease Prioritization (OHZDP) Evaluation Process Form UnchangedOHZDP Interest Intake Form
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedSurvey on Antimicrobial Resistance Among National Policy Audiences
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedInterview Guide for Consumers with Past Antimicrobial Resistant Infections on Antimicrobial Resistance
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedIn-Depth Interview Screener for Consumers with Previous Antimicrobial-Resistant Infections
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedFocus Group Guide for Caregivers about Antimicrobial Resistance
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedFocus Group Guide for General Consumers about Antimicrobial Resistance
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedFocus Group Screener for Consumers, Including Parents, and Caregivers
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedInterview Guide for Medical Association about Antimicrobial Resistance
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedFocus Group Guide for HCPs about Antimicrobial Resistance
265912 [NCZEID] Formative Communications Assessment on Antimicrobial Resistance Form UnchangedFocus Group Screener
265153 [NCEZID] Harmful Algal Blooms Communication Evaluation Form and Instruction UnchangedFocus Group Moderator Guide (24CX)
265153 [NCEZID] Harmful Algal Blooms Communication Evaluation Instruction Unchanged
265153 [NCEZID] Harmful Algal Blooms Communication Evaluation Form UnchangedEligible Participant Screener for Focus Group (24CX)
265153 [NCEZID] Harmful Algal Blooms Communication Evaluation Form UnchangedScreening/Eligibility Form for Focus Groups (24CX)
264920 [NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes Form and Instruction UnchangedMESSAGES 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 UnchangedModerator 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 UnchangedEligible Participant Screener (24CU)
264920 [NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes Form UnchangedScreening/Eligibility Form for Interviews/Focus Groups (24CU)
264849 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Form and Instruction UnchangedFocus Group Moderator Guide (24CP)
264849 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Other-Consent Unchanged
264849 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Form UnchangedEligible Participant Screener for Focus Group (24CP)
264849 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Form UnchangedScreening/Eligibility Form for Focus Groups
264809 (NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring Form and Instruction UnchangedAntifungal TDM Focus Group Guide
264809 (NCEZID) Focus Groups with Infectious Disease Physicians and Pharmacists on Antifungal Therapeutic Drug Monitoring Form and Instruction UnchangedAntifungal TDM Focus Group Screener
264581 [NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome Form and Instruction UnchangedAttachment 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 UnchangedAttachment 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 UnchangedAttachment 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 UnchangedAttachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23
264563 [NCIPC] Screening Survey for focus groups and interviews Form and Instruction UnchangedInterview Guide Tribal Health Care Providers (HCPs) and Tribal Leaders
264563 [NCIPC] Screening Survey for focus groups and interviews Form and Instruction UnchangedFocus Group Guide AI/AN Adults
264563 [NCIPC] Screening Survey for focus groups and interviews Instruction Unchanged
264563 [NCIPC] Screening Survey for focus groups and interviews Form UnchangedRecruitment Materials - Focus Groups and Interviews - AI/AN Adults
264149 [NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses Form and Instruction UnchangedFocus Group Guide
264149 [NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses Form and Instruction UnchangedFocus Group Consent Form
264149 [NCEZID] Focus Groups with Healthcare Providers on Endemic Mycoses Form and Instruction UnchangedFocus Group Screener
264017 [NICPC] Child Abuse and Neglect Prevention Message Development Form and Instruction UnchangedAtt 3. CAN Focus Group Eligible Participant Screener rev
264017 [NICPC] Child Abuse and Neglect Prevention Message Development Form and Instruction UnchangedAtt 3. CAN Focus Group Eligible Participant Screener 11.21.23
264017 [NICPC] Child Abuse and Neglect Prevention Message Development Form and Instruction UnchangedAtt 1. CAN Survey and Consent
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedCommunity Violence Focus Group Screening
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedCommunity Violence Focus Group
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedCommunity Violence Survey and Consent
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedFirearm Injury and Death Focus Group Screening
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedFirearm Injury and Death Focus Group
263776 [NCIPC] Formative Research for Firearm Violence and Community Violence Messaging Form and Instruction UnchangedFirearm Injury and Death Survey and Consent
263672 Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys) Other-Screenshots - Broadcast Radio Unchanged
263672 Message Evaluation for CDC's Stop Overdose Campaigns (Broadcast Radio & Digital Ad Surveys) Form and Instruction UnchangedStop 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 UnchangedStop Overdose Campaign Evaluation: Fentanyl and Naloxone Campaigns Survey - Broadcast Radio
263317 [OLSS] CDC OneLab REACH Formative Evaluation Form and Instruction ModifiedPace and non-Pace Evaluation Survey
263317 [OLSS] CDC OneLab REACH Formative Evaluation Form and Instruction ModifiedMini Lesson and Job Aid Survey
263317 [OLSS] CDC OneLab REACH Formative Evaluation Form and Instruction ModifiedUser Experience Survey
263317 [OLSS] CDC OneLab REACH Formative Evaluation Form and Instruction ModifiedPost Course Evaluation Survey
263317 [OLSS] CDC OneLab REACH Formative Evaluation Form and Instruction ModifiedSingle Sign-Up Survey - Revised 15JUL2025
263194 [CSELS/DLS]CDC OneLab Network Formative Evaluation Form and Instruction Unchanged04_Attachment 1_OneLab Network Survey_10-26-2023
261872 Feedback Survey for Community Counts Data Viz Tool Form and Instruction UnchangedFeedback Survey for Community Counts Data Viz Tool
261557 [NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases Form and Instruction UnchangedMODERATOR 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 UnchangedCONSENT 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 UnchangedRECRUITMENT SCREENER In-Depth Interviews with Hispanic or Latina Women
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 UnchangedAR 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 UnchangedTechnology 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 UnchangedRecruitment Screener
261060 [NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers Form and Instruction UnchangedAttmt III- Focus Group Guide - English_Spanish
261054 [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Other-Consent Unchanged
261054 [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Form and Instruction UnchangedTraining for Employers - Post-test
261054 [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Form and Instruction UnchangedTraining for Employers - Pre-test
261054 [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Form and Instruction UnchangedFocus Group Guide for Employees - English/Spanish
261054 [NIOSH] Increasing the Impact of NIOSH Heat Stress Products in Outdoor Worker Populations Form and Instruction UnchangedFocus Group Guide for Employers/Supervisors
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 UnchangedListening 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 UnchangedListening 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 UnchangedListening 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 UnchangedDSMES Provider Screener Script and Guidelines
259194 Formative Research for Spanish-Language Drug Overdose Messages Instruction Unchanged
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedRespondent Consent Form and Participants Email
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedOnline Survey
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedInterview Guide
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedFocus Group Moderator Guide
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedQualitative Eligibility Screener (Online)
259194 Formative Research for Spanish-Language Drug Overdose Messages Form and Instruction UnchangedQualitative Eligibility Screener (Phone)
259152 [CPR] Evaluation on Acceptability and Effectiveness of Pilot Project This is a Tabletop Exercise Simulation Tool (T.E.S.T.) Form and Instruction UnchangedAttachment 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 UnchangedAttachment 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 UnchangedAttachment B_Immediate Post Exercise Survey Questions
259053 [NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes Other-Screenshots of the Eligibility Screener for the Rapid Surv Unchanged
259053 [NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes Form and Instruction UnchangedRapid Survey
259053 [NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes Form and Instruction UnchangedEligibility Screener for Rapid Survey
259053 [NCEZID] Food Safety Communication Evaluation: Assessing Food Safety Messages, Knowledge, and Attitudes Form and Instruction UnchangedFocus 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 UnchangedEligibility Screener for Focus Group
ICR Details
0920-1154 202507-0920-010
Historical Active 202507-0920-005
HHS/CDC 0920-25-0059
[OS] CDC/ATSDR Formative Research and Tool Development
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 07/16/2025
Retrieve Notice of Action (NOA) 07/16/2025
  Inventory as of this Action Requested Previously Approved
03/31/2026 03/31/2026 03/31/2026
75,000 0 75,000
60,000 0 60,000
0 0 0

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 questions approved in GenIC - OneLab REACH (Rapid Education And Capacity-Building Hub) to be in accordance with EO [14168]. There is no change to the approved burden.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  87 FR 43860 07/22/2022
87 FR 62852 10/17/2022
No

61
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
[NCCDPHP] Health Surveys of Teens, Young Adults, and Parents of Children and Adolescents 0920-1154, 0920-1154, 0920-1154 Wave 3 - Parent Survey ,   Wave 3 - Young Adult Survey ,   Teen Pulse Survey
[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, 0920-25-0046, 0920-1154, 0920-1154, 0920-25-0046 Eligibility Screener - Focus Group ,   Eligible Participant Screener - Focus Group ,   Eligibility Screener - Survey ,   Focus Group Moderator Guide ,   Rapid Online Survey
[NCEZID] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community 0920-1154, 0920-1154, 0920-1154, 0920-1154 Discussion Guide - Leadership of hospitals and health systems ,   Survey - Leadership of hospitals and health systems ,   Discussion Guide - Frontline personnel of hospitals and health systems ,   Survey - Frontline personnel of hospitals and health systems
[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 Young Adults About Emergency Response Communication n/a, n/a, n/a Screener ,   Consent ,   Interview Guide
[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] Enhancing resilience of safe, quality care in US healthcare systems: discussions with members of the healthcare community 0920-25-0136 HSR Discussion Guide
[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, 0920-1154, n/a, n/a Single Sign-Up Survey - Revised 15JUL2025 ,   Post Course Evaluation Survey ,   User Experience Survey ,   Mini Lesson and Job Aid Survey ,   Pace and non-Pace Evaluation Survey
[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 Job Aid Surveys ,   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)
[ORR] Congregate Settings Infectious Disease Outbreak Tabletop Exercise (TTX) Hotwash and Survey 0920-1154, 0920-1154, 0920-1154 Hotwash Facilitation Guide ,   Participant Feedback Survey ,   TITLE 42—Authorizing Legislation

  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
No
No

$474,091
No
    No
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
07/16/2025