OMB control number

[NCCDPHP] Evaluation of a Prostate Cancer Decision Aid

OMB 0920-1438 · HHS/CDC.

OMB 0920-1438

To conduct a randomized controlled trial (RCT) to determine if CDC’s online, simulated, human decision aid module, Talk to Nathan About Prostate Cancer Screening (treatment arm), is effective in improving knowledge, overcoming health literacy barriers, and resolving decisional conflict compared to a standard decision aid (control arm 1) and standard education materials (control arm 2). Also, to identify barriers and best practices for incorporating Talk to Nathan About Prostate Cancer Screening into the flow of primary care practice.

The latest form for [NCCDPHP] Evaluation of a Prostate Cancer Decision Aid expires 2027-08-31 and is listed under ICR 202505-0920-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0920-24CB Pre-Exposure Survey_Online_Spanish	Form
Form 0920-24CB Pre-Exposure Survey_Online_English	Form
Form 0920-24CB Pre-exposure Survey	Form
Form 0920-24CB Patient Eligibility Screener_Spanish	Form
Form 0920-24CB Patient Eligibility Screener_English	Form
Form 0920-24CB Patient Eligibility Screener	Form
Form 0920-24CB Provider Survey	Form
Form 0920-24CB Provider Survey	Form
Form 0920-24CB Clinic Coordinator Interviews_Interview Guide	Form
Form 0920-24CB Clinic Coordinator Interview	Form
Form 0920-24CB Post-Clinic Visit Survey_Online_Spanish	Form
Form 0920-24CB Post-Clinic Visit Survey_Online_English	Form
Form 0920-24CB Post-clinic Survey	Form
Form 0920-24CB User Experience Interviews_Interview Guide_Spanish	Form
Form 0920-24CB User Experience Interviews_Interview Guide_English	Form
Form 0920-24CB User Experience Interview	Form
Form 0920-24CB Usability Survey_Online_Spanish	Form
Form 0920-24CB Usability Survey_Online_English	Form
Form 0920-24CB Usability Survey	Form
Form 0920-24CB Post Exposure Survey _Spanish	Form
Form 0920-24CB Post Exposure Survey _English	Form
Form 0920-24CB Post-exposure survey	Form
Change Request for CDC Prostate Cancer Screening Decision Aid Randomized Controlled Trial_2025April17.docx	Justification for No Material/Nonsubstantive Change
Change Request for CDC Prostate Cancer Screening Decision Aid Randomized Controlled Trial_2025April17.docx	Justification for No Material/Nonsubstantive Change
Attachment 13_Approved Privacy Narrative.pdf	Supplementary Document
Attachment 13_Approved Privacy Narrative.pdf	Supplementary Document
4_Prostate Cancer_SSB.docx	Supporting Statement B
4_Prostate Cancer_SSB.docx	Supporting Statement B
Attachment 14_Institutional Review Board Approval.docx	Supplementary Document
Attachment 14_Institutional Review Board Approval.docx	Supplementary Document
Attachment 03_Evaluation Questions and Indicators.docx	Supplementary Document
Attachment 03_Evaluation Questions and Indicators.docx	Supplementary Document
Attachment 02_Study Design Graphic.pdf	Supplementary Document
Attachment 02_Study Design Graphic.pdf	Supplementary Document
Attachment 01_Authorizing Legislation.pdf	Supplementary Document
Attachment 01_Authorizing Legislation.pdf	Supplementary Document
_List of Attachments_SSA & SSB.docx	Supplementary Document
_List of Attachments_SSA & SSB.docx	Supplementary Document
3_Prostate Cancer_SSA.docx	Supporting Statement A
3_Prostate Cancer_SSA.docx	Supporting Statement A
Pre-exposure Survey	Form
Pre-exposure Survey	Form
Pre-exposure Survey	Form
Patient Eligibility Screener	Form
Patient Eligibility Screener	Form
Patient Eligibility Screener	Form
Provider Survey	Form
Provider Survey	Form
Clinic Coordinator Interview	Form
Clinic Coordinator Interview	Form
Post-clinic Survey	Form
Post-clinic Survey	Form
Post-clinic Survey	Form
User Experience Interview	Form
User Experience Interview	Form
User Experience Interview	Form
Usability Survey	Form
Usability Survey	Form
Usability Survey	Form
Post-exposure survey	Form
Post-exposure survey	Form
Post-exposure survey	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202505-0920-004	No material or nonsubstantive change to a currently approved collection	2025-05-14
202407-0920-009	New collection (Request for a new OMB Control Number)	2024-08-06		Approved without change

OMB Details

Post-exposure survey

Federal Enterprise Architecture: Health - Illness Prevention

Information collection instruments
Form	Name	Electronic access	Type
Form 0920-24CB	Post Exposure Survey _English	Fillable Fileable	Form
Form 0920-24CB	Post Exposure Survey _Spanish	Fillable Fileable	Form

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