OMB control number

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category A, Diabetes Management and Type 2 Diabetes Prevention

OMB 0920-1312 · HHS/CDC.

OMB 0920-1312

The cooperative agreement 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 Category A of the cooperative agreement: Diabetes Management and Type 2 Diabetes Prevention, The purpose of data collection is to evaluate how states are using funds and determine how those efforts are contributing to state, health system, or other organization level changes/outcomes related to diabetes.

The latest form for National Evaluation of the DP18-1815 Cooperative Agreement Program: Category A, Diabetes Management and Type 2 Diabetes Prevention expires 2023-12-31 and is listed under ICR 201910-0920-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
National DPP Lifestyle Coach Interview	Form and Instruction
National DPP Program Coordinator Interview	Form and Instruction
National DPP Partner Site-Level Rapid Evaluation Survey	Form and Instruction
DSMES Paraprofessional Team Member Interview	Form and Instruction
DSMES Professional Team Member Interview	Form and Instruction
DSMES Program Coordinator Interview	Form and Instruction
DSMES Partner Site-Level Rapid Evaluation Survey	Form and Instruction
National DPP Partner Site-Level Rapid Evaluation Nomination	Form and Instruction
DSMES Partner Site-Level Rapid Evaluation Nomination	Form and Instruction
Recipient-Led Evaluation Reporting	Form and Instruction
Evaluation and Performance Measurement Plan (EPMP)	Form and Instruction
Att 8d. Cat A Site Rapid Eval Fnl Rem Comm.docx	Supplementary Document
Att 8c. Cat A Site Rapid Eval Survey Rem Comm.docx	Supplementary Document
Att 8b. Cat A Site Rapid Eval Invit Comm.docx	Supplementary Document
Att 8a. Cat A Site Rapid Eval Pre Survey Comm_v02.docx	Supplementary Document
Att 7a. Inst Rev Brd App Det Pt B.pdf	Supplementary Document
Att 7a. Inst Rev Brd App Det Pt A.pdf	Supplementary Document
Att 6. 60-day FRN.pdf	Supplementary Document
Att 3f. Cat A 1815 Eval Gantt Chart.xlsx	Supplementary Document
Att 3e. Cat A 1815 Summ of Annual Resp_v06.docx	Supplementary Document
Att 3d. Cat A Crosswalk of Eval Comp_Data Coll.Tool.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 the PH Serv Act.pdf	Supplementary Document
Att 1. CDC-RFA-DP18-1815PPHF18.pdf	Supplementary Document
SSB_1815 Category A_v09.docx	Supporting Statement B
SSA_1815 Category A_v09.docx	Supporting Statement A
National DPP Lifestyle Coach Interview	Form and Instruction
National DPP Program Coordinator Interview	Form and Instruction
National DPP Partner Site-Level Rapid Evaluation Survey	Form and Instruction
DSMES Paraprofessional Team Member Interview	Form and Instruction
DSMES Professional Team Member Interview	Form and Instruction
DSMES Program Coordinator Interview	Form and Instruction
DSMES Partner Site-Level Rapid Evaluation Survey	Form and Instruction
National DPP Partner Site-Level Rapid Evaluation Nomination	Form and Instruction
DSMES Partner Site-Level Rapid Evaluation Nomination	Form and Instruction
Recipient-Led Evaluation Reporting	Form and Instruction
Evaluation and Performance Measurement Plan (EPMP)	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201910-0920-009	New collection (Request for a new OMB Control Number)	2020-05-15		Approved with change

OMB Details

Evaluation and Performance Measurement Plan (EPMP)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
Form	Name	Electronic access	Type
Form n/a	Evaluation and Performance Measurement Plan (EPMP)	Fillable Fileable	Form and instruction

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