OMB control number
Assessment of the Cancer Survivorship Demonstration Project
OMB 0920-1250 ยท HHS/CDC.
OMB 0920-1250
This Information collection aims to assess six Division of Cancer Prevention and Control National Comprehensive Cancer Control Program DP15-1501-funded grantees' efforts. The assessment will determine their ability to implement evidence-based and promising strategies to increase knowledge of cancer survivor needs, increase utilization of surveillance data to inform program planning by providers and coalition members, and enhance partnerships to facilitate and broaden program reach. Information will be collected from DP15-1501 grantee staff and partners in two waves via Web-based surveys and semistructured telephone interviews.
The latest form for Assessment of the Cancer Survivorship Demonstration Project expires 2022-02-28 and is listed under ICR 201811-0920-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Web-based Partner Survey | Form |
| Web-based Grantee Survey | Form |
 Att 6_RTI IRB Decision Memo.pdf | Supplementary Document |
| Att 5_Intro Data Collection Email to DP15-1501 Grantees.docx | Supplementary Document |
| Att 3i_Web-based Survey Items By Respondent Type.docx | Supplementary Document |
| Att 2_60 Day FRN Published.pdf | Supplementary Document |
| Att 1_Section 301 of the Public Health Service Act.pdf | Supplementary Document |
| Supporting Statement B_CDC Survivorship.docx | Supporting Statement B |
| Supporting Statement A_CDC Survivorship - QNH edits CLEAN.docx | Supporting Statement A |
 Telephone Interview |
Other-Interview Guide |
| Web-based Partner Survey |
Form |
| Web-based Grantee Survey |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201811-0920-001 | New collection (Request for a new OMB Control Number) | 2018-11-20 | Approved with change |
OMB Details
Web-based Grantee Survey
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form none | Grantee Survey - screenshots | Fillable Fileable | Form |
| Form none | Grantee Survey | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.