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

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 can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
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All Historical Document Collections

201906-0920-006

Approved without change

New collection (Request for a new OMB Control Number)

2019-07-05

OMB Details

Healthcare Professionals Survey

Federal Enterprise Architecture: Health - Health Care Services