OMB control number

The Centers for Disease Control and Prevention (CDC) Study on Disparities in Distress Screening among Lung and Ovarian Cancer Survivors

OMB 0920-1270 · HHS/CDC.

OMB 0920-1270

The purpose of this study is to examine the extent to which disparities exist in distress screening and follow-up care among cancer treatment facilities and programs across the country. CDC believes that it is imperative to develop a greater understanding about the types of services for lung and ovarian cancer survivors because they experience high levels of distress and are among those who experience the lowest 5-year survival rates.

The latest form for The Centers for Disease Control and Prevention (CDC) Study on Disparities in Distress Screening among Lung and Ovarian Cancer Survivors expires 2020-10-31 and is listed under ICR 201906-0920-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0920-19MM Focus Groups	Form and Instruction
Form 0920-19MM Key Informant Interview Guide and Consent	Form and Instruction
Form 0920-19MM EHR Data	Form and Instruction
Privacy Narrative Cancer Distress Screening Final.pdf	Supplementary Document
Distress Screeening SSA final.doc	Supporting Statement A
Att 6a - Westat Continuing IRB Approval DS.pdf	Supplementary Document
Att 6 - Westat Initial IRB Approval DS.pdf	Supplementary Document
Att 5c - FU email to schedule potential interviewees DS.docx	Supplementary Document
Att 5b - Email invitation to potential interviewees DS.docx	Supplementary Document
Att 5a - Int & focus grp respondent info form DS.docx	Supplementary Document
Att 3d - Healthcare facilities IRB info DS.docx	Supplementary Document
Att 3c - FAQs DS.docx	Supplementary Document
Att 3b - Initial recruitment email to study partners DS.docx	Supplementary Document
Att 3a - Initial recruitment email to potential healthcare facilities DS.docx	Supplementary Document
Att 2 60-day FRN DS.pdf	Supplementary Document
Att 1 - Authorizing Legislation DS.doc	Supplementary Document
Distress Screening SSB.docx	Supporting Statement B
Focus Groups	Form and Instruction
Key Informant Interview Guide and Consent	Form and Instruction
EHR Data	Form and Instruction
Healthcare Professionals Survey	Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201906-0920-006	New collection (Request for a new OMB Control Number)	2019-07-05		Approved without change

OMB Details

Healthcare Professionals Survey

Federal Enterprise Architecture: Health - Health Care Services