OMB control number

[NCCDPHP] Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

OMB 0920-0612 · HHS/CDC.

OMB 0920-0612

The WISEWOMAN program focuses on reducing risk factors for cardiovascular disease (CVD) among at-risk participants. Addressing risk factors such as high blood pressure, elevated blood cholesterol, obesity, sedentary lifestyle, diabetes, and smoking, reduces a woman’s risk of CVD-related illness and death. CVD, is a primary contributor to mortality, morbidity, and decreased quality of life, especially among older participants. Health United States (2019) reported that CVD was the leading cause of death for women in the United States. Participants in lower income brackets, or without health insurance have an increased risk of CVD morbidity and mortality, because they have limited access to health services such as screenings, medications, healthy behavior support services to manage their risk factors. State, and tribal organizations awarded with WISEWOMAN grants are expected to report information pertaining to the aforementioned factors for the purposes of program evaluation. The WISEWOMAN program shares 8 data elements with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) so the burden of collecting additional information by awardees (see Attachment 3) is minimized. Overall, there are no changes to the number of awardees (respondents), the information collection requirements, the estimated burden per response, or the total estimated annualized burden hours. This Revision request for WISEWOMAN Program replaces the current race MDE with OMB 2024 Statistical Policy Directive-15 Standard (Figure 2). Two additional questions from the PRAPARE Screening Tool will be added for program fidelity and data quality.

The latest form for [NCCDPHP] Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System expires 2028-08-31 and is listed under ICR 202502-0920-014.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0621 WISEWOMAN-MDE_Manual_23.1Form and Instruction
Form 0920-0612 WISEWOMAN Program MDE Manual Edition 18.3RForm and Instruction
Form 0920-0612 WISEWOMAN Program Minimum Data Elements (MDE)Form and Instruction
Form 0920-0621 WISEWOMAN-MDE_Annual Progress ReportForm and Instruction
WISEWOMAN Annual Progress ReportForm and Instruction
Annual Progress ReportForm and Instruction
Attachment 9 Summary Exhibits_Minor Changes_04082025.pdfSupplementary Document
WISEWOMAN 0920-0612 SSB F_Updated_04072025.docxSupporting Statement B
WISEWOMAN 0920-0612 SSA F_Updated_04072025.docxSupporting Statement A
WISEWOMAN SPD-15 Justification.docxSupplementary Document
Attachment 1b WISEWOMAN Program Managers Directors and Data Managers.pdfSupplementary Document
Attachment 5b Web Portal Upload Screen Shot.pdfSupplementary Document
Attachment 5a Web Portal Login Screen.pdfSupplementary Document
Attachment 7c Summary of Public Comments.pdf (document unavailable)Public Comments
Attachment 7c Summary of Public Comments.pdf (document unavailable)Public Comments
Attachment 7c Summary of Public Comments.pdf (document unavailable)Public Comments
Attachment 7b_WISEWOMANFederalRegisterNotice2024.pdfSupplementary Document
Attachment 1a Map of WISEWOMAN Awardees.pdfSupplementary Document
OMB Change Request_08182023.docxJustification for No Material/Nonsubstantive Change
OMB Change Request_04182023.docxJustification for No Material/Nonsubstantive Change
Att 7 Consent Guidance.pdfSupplementary Document
60-day FRN_06022022.pdfSupplementary Document
Att 2b WISEWOMAN Prg Mgrs Dirs Data Mgrs.pdfSupplementary Document
Att 2a WISEWOMAN Awardees Map.pngSupplementary Document
Att 1b Sec 301 PHSA.pdfSupplementary Document
Att 1a NBCCEDP Law Statute.pdfSupplementary Document
WISEWOMAN Program Minimum Data Elements (MDE) Form and Instruction
WISEWOMAN Program Minimum Data Elements (MDE) Form and Instruction
WISEWOMAN Program Minimum Data Elements (MDE) Form and Instruction
WISEWOMAN Program Minimum Data Elements (MDE) Instruction
Annual Progress Report Form and Instruction
Annual Progress Report Form and Instruction
Annual Progress Report Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202502-0920-014 Reinstatement with change of a previously approved collection 2025-06-25
202308-0920-009 No material or nonsubstantive change to a currently approved collection 2023-08-23 Approved without change
202304-0920-005 No material or nonsubstantive change to a currently approved collection 2023-04-19 Approved without change
202208-0920-002 Extension without change of a currently approved collection 2022-08-16 Approved without change
202010-0920-002 No material or nonsubstantive change to a currently approved collection 2020-10-08 Approved without change
202004-0920-014 No material or nonsubstantive change to a currently approved collection 2020-04-21 Approved without change
202003-0920-006 No material or nonsubstantive change to a currently approved collection 2020-03-12 Approved without change
201905-0920-005 Reinstatement without change of a previously approved collection 2019-06-05 Approved without change
201804-0920-005 No material or nonsubstantive change to a currently approved collection 2018-04-12 Approved without change
201611-0920-003 Extension without change of a currently approved collection 2016-11-08 Approved without change
201608-0920-004 No material or nonsubstantive change to a currently approved collection 2016-08-10 Approved without change
201310-0920-006 Revision of a currently approved collection 2013-10-30 Approved without change
201301-0920-004 Extension without change of a currently approved collection 2013-01-04 Approved without change
201101-0920-002 No material or nonsubstantive change to a currently approved collection 2011-01-18 Approved with change
201001-0920-007 Revision of a currently approved collection 2010-01-27 Approved without change
200611-0920-004 Extension without change of a currently approved collection 2006-11-22 Approved without change
200605-0920-006 No material or nonsubstantive change to a currently approved collection 2006-05-03 Approved without change
200309-0920-008 New collection (Request for a new OMB Control Number) 2003-09-30 Approved with change

OMB Details

WISEWOMAN Program Minimum Data Elements (MDE)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0612WISEWOMAN Program MDE Manual Edition 18.3RFillable FileableForm and instruction
Form 0920-0621WISEWOMAN-MDE_Manual_23.1N/AForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.