[NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920 Instrument and Protocol Surveillance Capacity Assessment (SCA)	Form and Instruction	Modified	Available
Form 0920-26-0228 Surveillance Capacity Assessment	Form and Instruction	Modified	Available
Form 0920 Instrument and Protocol Key Informant Interview - Principal Investigators	Form and Instruction	Modified	Available
Form 0920-26-0228 Instrument and Protocol Key Informant Interview - Principal Investigators	Form and Instruction	Modified	Available
Form 0920-26-0228 Instrument and Protocol Key Informant Interview - Principal Investigators	Form and Instruction	Modified	Available
Form 0920-26-0228 Annual Performance Report (APR)	Form	Modified	Available
Att. 8 Research Determination.pdf	Supplementary Document	Uploaded 2026-09-30	Available
Att. 7 EfC Privacy Assessment.pdf	Supplementary Document	Uploaded 2026-09-30	Available
Att. 1_PHSA_301a_USC_241a and Section 393USC 280b-1a.pdf	Supplementary Document	Uploaded 2026-09-30	Available
0920-1425 EfC Updates Crosswalk.xlsx	Supplementary Document	Uploaded 2026-09-30	Available
Att 2a Public comments and responses EfC 1425 2026.pdf	Public Comments	Uploaded 2026-09-28	Available
Change Request Memo - Essentials for Childhood 072125.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-22	Available
SSB_EfC_Program_2026_v02.docx	Supporting Statement B	Uploaded 2026-09-28	Available
SSA_EfC Program_Revision 2026 V02.docx	Supporting Statement A	Uploaded 2026-09-28	Available
Att. 8 Research Determination.pdf	Supplementary Document	Uploaded 2023-10-12	Available
Att. 7 EfC-ICR-PII-Privacy Act-Determination.pdf	Supplementary Document	Uploaded 2023-10-12	Available
Att. 1_PHSA_301a_USC_241a and Section 393USC 280b-1a.pdf	Supplementary Document	Uploaded 2023-10-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
262779	Implementation Capacity Assessment (ICA)	Form and Instruction	Modified	Instrument and Protocol Surveillance Capacity Assessment (SCA)
262777	Essentials Instrument and Protocol Evaluation and Surveillance Survey	Form and Instruction	Modified	Surveillance Capacity Assessment
262776	Evaluation and Surveillance Survey	Form and Instruction	Modified	Instrument and Protocol Key Informant Interview - Principal Investigators
262775	Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer	Form and Instruction	Modified	Instrument and Protocol Key Informant Interview - Principal Investigators
262773	Instrument and Protocol Key Informant Interview - Principal Investigators	Form and Instruction	Modified	Instrument and Protocol Key Informant Interview - Principal Investigators
262771	Annual Performance Report (APR) Tool	Form	Modified	Annual Performance Report (APR)

ICR Details

OMB Control No: 0920-1425	ICR Reference No: 202609-0920-008
Status: Received in OIRA	Previous ICR Reference No: 202507-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0228
Title: [NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/30/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2026
Responses	72	72
Time Burden (Hours)	129	168
Cost Burden (Dollars)	0	0

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Abstract: The goal of this ICR is to collect data to monitor project performance from grantees funded under Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action. Information collected from recipients will be used to monitor and evaluate progress of program goals and objectives, identify technical assistance needs, and be accountable for the funding by responding to requests for information about the cooperative agreement. The population studied will include 100% of EfC-funded recipients. Therefore, a sampling method is not required. Recipients will report performance data to CDC annually using a web-based system (i.e., Partners’ Portal). No research design or human subjects involved. Information will be also collected via virtual interview sessions. Quantitative data will be analyzed using descriptive and summary statistics. Qualitative data will be analyzed through thematic analysis to define priority area topics and emerging themes. Substantial revisions were made to streamline the reporting process and comply with CDC’s priorities and Presidential Executive Orders EO 14168 “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and EO 14151 “Ending Radical and Wasteful Government DEI Programs and Preferencing”. This Non-Substantive Change Request is submitted for compliance with recently issued EOs 14168 and 14151. There is no anticipated change to the approved burden.

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Authorizing Statute(s): US Code: 42 USC 301(a) 241a Name of Law: Public Health Service Act
  

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:
	91 FR 36838	06/18/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 61233	09/28/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Annual Performance Report (APR) Tool	0920-26-0228	Annual Performance Report (APR)
Essentials Instrument and Protocol Evaluation and Surveillance Survey	0920-26-0228	Surveillance Capacity Assessment
Evaluation and Surveillance Survey	0920	Instrument and Protocol Key Informant Interview - Principal Investigators
Implementation Capacity Assessment (ICA)	0920	Instrument and Protocol Surveillance Capacity Assessment (SCA)
Instrument and Protocol Key Informant Interview - Principal Investigators	0920-26-0228	Instrument and Protocol Key Informant Interview - Principal Investigators
Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer	0920-26-0228	Instrument and Protocol Key Informant Interview - Principal Investigators

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ICR Summary of Burden

table that charts list 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	72	72	0	0	0	0
Annual Time Burden (Hours)	129	168	0	-39	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: This revision request is for three years of approval and approximately 129 Hours of annual burden.

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Annual Cost to Federal Government: $116,646

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 09/30/2026

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