National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

OMB 0920-1046

The goal of this data collection is to systematically collect information about the implementation and outcomes of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which funds 70 grantees. CDC will conduct an annual grantee survey and collect clinic-level information from grantees’ health system partners. The subpopulation for the grantee survey is the 70 NBCCEDP program directors/program managers. Clinic-level information, including breast and cervical screening rates, represents clients ages 50-74 for breast cancer screenings and 21-65 for cervical cancer screenings within partner health systems. This information collection will allow CDC to conduct routine monitoring, tailor technical assistance, support program planning, and assess program outcomes.

The latest form for National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities expires 2021-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1046 Minimum Data Elements (MDE) Data Definition Table Form and Instruction
Form 0920-1046 NBCCEDP Service Delivery Projection Worksheet Form and Instruction
Form 0920-1046 NBCCEDP Quarterly Program Update Form and Instruction
Form 0920-1046 NBCCEDP Clinic-Level Data Instrument (Cervical) Form and Instruction
Form 0920-1046 NBCCEDP Clinic-Level Data Collection Instruments Form and Instruction
Form 0920-1046 Annual NBCCEDP Survey Form and Instruction
0920-1046_PIA final.pdf Supplementary Document
Att 10 - Institutional Review Board Approval.docx Supplementary Document
Att 11 - NBCCEDP 60-Day FRN.pdf Supplementary Document
Att 4 -NBCCEDP Evaluation Question Matrix.docx Supplementary Document
Att 3 - DP22-2202 NBCCEDP Logic Model.docx Supplementary Document
Att 2 - Breast and Cervical Cancer Mortality Prevention Act of 1990.pdf Supplementary Document
Att 1 - Authorizing Legislation.pdf Supplementary Document
0920-1046 SS Part B_Final.docx Supporting Statement B
SS Part A_Final.v2_0920-1046.docx Supporting Statement A
Minimum Data Elements (MDE) Data Definition Table Form and Instruction
NBCCEDP Service Delivery Projection Worksheet Form and Instruction
NBCCEDP Quarterly Program Update Form and Instruction
NBCCEDP Clinic-Level Data Instrument (Cervical) Form and Instruction
NBCCEDP Clinic-Level Data Collection Instruments Form and Instruction
Annual NBCCEDP Survey Form and Instruction

All Historical Document Collections

202111-0920-005 Approved without change	Revision of a currently approved collection	2021-11-18
202009-0920-022 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-09-28
201805-0920-008 Approved without change	Reinstatement with change of a previously approved collection	2018-10-31
201410-0920-018 Approved without change	New collection (Request for a new OMB Control Number)	2014-10-27

OMB Details

NBCCEDP Annual Grantee Survey

Federal Enterprise Architecture: Health - Consumer Health and Safety

Form n/a

NBCCEDP Annual Grantee Survey

Fillable Fileable

Form and instruction

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