OMB control number

Musculoskeletal Disorder (MSD) Intervention Effectiveness in an Insurer-Supported Engineering Control Program

OMB 0920-0907 · HHS/CDC.

OMB 0920-0907

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Early Exit Interview - Additional Data Collection	Form and Instruction
Self-Reported General Work Environment and Health Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Specific Job Tasks and Safety Incidents Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Low Back Questionnaire - Additional Data Collection	Form and Instruction
Early Exit Interview - Original Data Collection	Form and Instruction
Form 7 Low Back Functional Assessment	Form and Instruction
Self-Reported General Work Environment and Health Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Specific Job Tasks and Safety Incidents Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Low Back Pain Questionnaire - Original Data Collection	Form and Instruction
Form 2 Informed Consent- Low Back Functional Assessment	Form and Instruction
Informed Consent (Questionnaire Data Collection)	Form and Instruction
Attachment L-5 Study Limitations.docx	Supplementary Document
Attachment L-3 MSD Study Outcomes.docx	Supplementary Document
Attachment L-1 Interventions.docx	Supplementary Document
Attachment K IRB Approval.docx	Supplementary Document
Attachment J-4 Indiv Recruitment Flyer.docx	Supplementary Document
Attachment J-3 OBWC Safety Grant 2.docx	Supplementary Document
Attachment J-2 OBWC Safety Grant 1.docx	Supplementary Document
Attachment J-1 Recruitment Flyer.docx	Supplementary Document
Attachment G-3 Photograph Consent.docx	Supplementary Document
Attachment G-1 Informed Consent.docx	Supplementary Document
Attachment F Information Security.docx	Supplementary Document
Attachment E-3 US_Ohio Codes.docx	Supplementary Document
Attachment E-2 OBWC Letter of Support.docx	Supplementary Document
Attachment E-1 OBWC_NIOSH Agreement.docx	Supplementary Document
Attachment D-2 MSD Intervention Studies.docx	Supplementary Document
Attachment D-1 Relation to CDC Research.docx	Supplementary Document
Attachment C NIOSH Strategic Goals.docx	Supplementary Document
Attachment B 60d FRN.pdf	Supplementary Document
Attachment A Authorizing Legislation.docx	Supplementary Document
Section B MSD Intervention 2_10_15.docx	Supporting Statement B
Section A MSD Intervention 2_09_15.docx	Supporting Statement A
Early Exit Interview - Additional Data Collection	Form and Instruction
Self-Reported General Work Environment and Health Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Specific Job Tasks and Safety Incidents Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Additional Data Collection	Form and Instruction
Self-Reported Low Back Questionnaire - Additional Data Collection	Form and Instruction
Early Exit Interview - Original Data Collection	Form and Instruction
Low Back Functional Assessment	Form and Instruction
Self-Reported General Work Environment and Health Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Specific Job Tasks and Safety Incidents Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Original Data Collection	Form and Instruction
Self-Reported Low Back Pain Questionnaire - Original Data Collection	Form and Instruction
Informed Consent- Low Back Functional Assessment	Form and Instruction
Informed Consent (Questionnaire Data Collection)	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201409-0920-008	Revision of a currently approved collection	2014-09-17		Approved with change
201108-0920-004	New collection (Request for a new OMB Control Number)	2011-08-15		Approved with change