OMB control number

Stakeholder Interviews for the Evaluation of the World Trade Center Health Program for Impact Assessment and Strategic Planning for Translational Research

OMB 0920-1280 · HHS/CDC.

OMB 0920-1280

The World Trade Center Health Program (WTCHP) was established by the James Zadroga 9/11 Health and Compensation Act of 2010. As required by the Act, the WTCHP carries out a robust research program while providing critical monitoring and treatment services for its 75,000 members, who include responders at the World Trade Center (WTC) and related sites and survivors who were in the New York City disaster area. The research mission is to identify physical and mental health conditions that may be related to the 9/11 terrorist attacks and define effective diagnostic procedures and treatments for WTC-related health conditions. The Research to Care (RTC) model is the theoretical framework used by NIOSH to prioritize, conduct, and assess research that informs clinical care for WTCHP members. NIOSH proposes to conduct interviews with representatives of different stakeholder groups to explore their perspectives on translational research in the context of the WTCHP.

The latest form for Stakeholder Interviews for the Evaluation of the World Trade Center Health Program for Impact Assessment and Strategic Planning for Translational Research expires 2023-01-31 and is listed under ICR 201907-0920-006.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
WTCHP Brief Demographic Survey	Form and Instruction
WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Form and Instruction
Att H_NIOSH IRB-Determination-Form-tcv 041718.pdf	Supplementary Document
Att F_RAND IRB determination_08282018.pdf	Supplementary Document
Att E_Recruitment materials.docx	Supplementary Document
Att C_Consent_2019-07-30.docx	Supplementary Document
Att B_60day FRN.pdf	Supplementary Document
Att A_Legislation_08282018.docx	Supplementary Document
WTCHP SSB interviews 2019-07-30.docx	Supporting Statement B
WTCHP SSA interviews 2019-07-30.docx	Supporting Statement A
Interviews with WTCHP Responders and Survivors (private citizens)	Form and Instruction
Interviews with WTCHP Responders and Survivors (private citizens)	Form and Instruction
Interviews with WTCHP Responders and Survivors (state/local govt)	Form and Instruction
Interviews with WTCHP Responders and Survivors (state/local govt)	Form and Instruction
Interviews with Clinicians Caring for WTCHP Members	Form and Instruction
Interviews with Clinicians Caring for WTCHP Members	Form and Instruction
Interviews with WTC Health Registry Staff	Form and Instruction
Interviews with WTC Health Registry Staff	Form and Instruction
Interviews with Leadershp from WTC Clinical Centers of Excellence	Form and Instruction
Interviews with Leadershp from WTC Clinical Centers of Excellence	Form and Instruction
Interviews with Principal Investigators of WTCHP-funded Research	Form and Instruction
Interviews with Principal Investigators of WTCHP-funded Research	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201907-0920-006	New collection (Request for a new OMB Control Number)	2019-08-13		Approved without change

OMB Details

Interviews with Principal Investigators of WTCHP-funded Research

Federal Enterprise Architecture: Workforce Management - Worker Safety

Information collection instruments
Form	Name	Electronic access	Type
Form n/a	WTCHP Impact Assessment and Strategic Planning In-depth Interview Discussion Guide	Paper Only	Form and instruction
Form n/a	WTCHP Brief Demographic Survey	Fillable Fileable	Form and instruction

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