OMB control number

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category B, Cardiovascular Disease Prevention and Management

OMB 0920-1311 · HHS/CDC.

OMB 0920-1311

The cooperative agreement, Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke, supports state investments in implementing and evaluating evidence-based strategies to prevent and manage diabetes and cardiovascular disease (CVD). This information collection request focuses on activities conducted under cooperative agreement Category B: Cardiovascular Disease (CVD) Prevention and Management. The purpose of data collection is to evaluate how states are using CDC DP18-1815 funds to implement evidence-based strategies, and determine how those efforts are contributing to state, health system, or other organization level changes/outcomes related to CVD.

The latest form for National Evaluation of the DP18-1815 Cooperative Agreement Program: Category B, Cardiovascular Disease Prevention and Management expires 2023-12-31 and is listed under ICR 202003-0920-010.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Cost Study Resource Use and Cost Inventory Tool – Partner/Site Level	Form and Instruction
CCL Partner Site-Level Informant Interview	Form and Instruction
MTM Partner Site-Level Interview	Form and Instruction
TBC Partner Site-Level Interview	Form and Instruction
CQM Partner Site-Level Interview	Form and Instruction
Recipient-Led Evaluation Annual Report Template	Form and Instruction
Cost Study Resource Use and Cost Study Inventory Tool - Health Departments	Form and Instruction
CCL Group Discussion	Form and Instruction
CCL Health Department Interview	Form and Instruction
TBC Group Discussion	Form and Instruction
MTM Health Department Interview	Form and Instruction
TBC Health Department Interview	Form and Instruction
CQM Group Discussion	Form and Instruction
CQM Health Department Interview	Form and Instruction
SSA_1815 Category B_National Evaluation_v06_10-11-21.docx	Justification for No Material/Nonsubstantive Change
Att 9e. Cat B Case Study Follow Up Email.docx	Supplementary Document
Att 9d. Cat B Case Study Rem Email.docx	Supplementary Document
Att 9c. Cat B Case Study Confirm Email.docx	Supplementary Document
Att 9b. Cat B Case Study Partner Site Invite.docx	Supplementary Document
Att 9a. Cat B Case Study HD Invite_rev.docx	Supplementary Document
Att 8b. Inst Rev Board App Not_Exemp Det_Pt B.PDF	Supplementary Document
Att 8a. Inst Rev Board App Not_Exemp Det_Pt A.pdf	Supplementary Document
Att 7. 60-day FRN.pdf	Supplementary Document
Att 3f. Cat B 1815 Eval Gantt Chart.xlsx	Supplementary Document
Att 3e. Cat B 1815 Summ of Annual Resp.docx	Supplementary Document
Att 3d. Cat B Crosswalk Eval Comp_Data Coll Tools.docx	Supplementary Document
Att 3c. 1815 Logic Model.docx	Supplementary Document
Att 3b. 1815 Strat Prev_Control.docx	Supplementary Document
Att 3a. 1815 List of HD Awardees.docx	Supplementary Document
Att 2. Auth Leg Sec 301a of PH Serv Act.pdf	Supplementary Document
Att 1. CDC-RFA-DP18-1815PPHF18.pdf	Supplementary Document
SSB_1815 Category B_v06_rev.docx	Supporting Statement B
SSA_1815 Category B_v06_rev.docx	Supporting Statement A
Cost Study Resource Use and Cost Inventory Tool – Partner/Site Level	Form and Instruction
CCL Partner Site-Level Informant Interview	Form and Instruction
MTM Partner Site-Level Interview	Form and Instruction
TBC Partner Site-Level Interview	Form and Instruction
CQM Partner Site-Level Interview	Form and Instruction
Recipient-Led Evaluation Annual Report Template	Form and Instruction
Cost Study Resource Use and Cost Study Inventory Tool - Health Departments	Form and Instruction
CCL Group Discussion	Form and Instruction
CCL Health Department Interview	Form and Instruction
TBC Group Discussion	Form and Instruction
MTM Health Department Interview	Form and Instruction
TBC Health Department Interview	Form and Instruction
CQM Group Discussion	Form and Instruction
CQM Health Department Interview	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202110-0920-012	No material or nonsubstantive change to a currently approved collection	2021-10-27		Approved with change
202003-0920-010	New collection (Request for a new OMB Control Number)	2020-05-15		Approved with change

OMB Details

CQM Health Department Interview

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
Form	Name	Electronic access	Type
Form n/a	CQM State Health Department Interview Guide	Paper Only	Form and instruction

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