OMB control number

[NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program

OMB 0920-1453 · HHS/CDC.

OMB 0920-1453

The purpose of the project is to conduct a comprehensive implementation and outcome evaluation to assess the unique contributions of The National Cardiovascular Health Program (The National CVH Program), The Innovative Cardiovascular Health Program (The Innovative CVH Program), and Well-Integrated Screening and Evaluation of Women Across the Nation (WISEWOMAN) cooperative agreements to identify promising cardiovascular disease (CVD) prevention and management practices that can be scaled and replicated, advance health equity, and the transformation of health systems for improved CVD prevention and management. The programs work together to create efficiencies and improve outcomes in jurisdictions that receive funding for two or more of the cooperative agreements. This Evaluation aims to assess implementation, assess the extent to which short-term, intermediate, and long-term outcomes have been met, and estimate the costs involved in program implementation. This Non-Substantive Change Request is submitted to revise questions to align with recent executive orders, EO 14168 and EO 14151. There is no change anticipated to the currently approved burden hours.

The latest form for [NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program expires 2027-12-31 and is listed under ICR 202504-0920-030.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0920-1453 Att 4a. Ex Assessment_LC_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a)	Form and Instruction
Form 0920-1453 Att 3c. Eval Assessment_LC_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)	Form and Instruction
Form 0920-24FI Cost Study – Partner Interview Guide	Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b)	Form and Instruction
Form 0920-1453 Att 5d. Cost Study_Interview Guide_Partners_rev 2025	Form and Instruction
Form 0920-1453 Cost Study Interview Guide_Partner (Attachment 5d)	Form and Instruction
Form 0920-1453 Att 4m. Ex Assessment_CCL_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m)	Form and Instruction
Form 0920-1453 Att 4l. Ex Assessment_CCL_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l)	Form and Instruction
Form 0920-1453 Att 4i. Ex Assessment_TBC_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i)	Form and Instruction
Form 0920-1453 Att 4h. Ex Assessment_TBC_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h)	Form and Instruction
Form 0920-1453 Att 4e. Ex Assessment_CQM_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e)	Form and Instruction
Form 0920-1453 Att 4d. Ex Assessment_CQM_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d)	Form and Instruction
Form 0920-1453 Att 3o. Eval Assessment_CCL_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CCL Partner Interview Guide WW (Attachment 3o)	Form and Instruction
Form 0920-1453 Att 3n. Eval Assessment_CCL_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Att 3k. Eval Assessment_TBC_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide WW (Attachment 3k)	Form and Instruction
Form 0920-1453 Att 3j. Eval Assessment_TBC_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j)	Form and Instruction
Form 0920-1453 Att 3g. Eval Assessment_CQM_Partner_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide WW (Attachment 3g)	Form and Instruction
Form 0920-1453 Att 3f. Eval Assessment_CQM_Partner_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f)	Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool (Recipient)	Form and Instruction
Form 0920-24FI Cost Study – Recipient Interview Guide	Form and Instruction
Form 0920-24FI Cost Study Interview Guide_Recipient (Attachment 5c)	Form and Instruction
Form 0920-1453 Att 4k. Ex Assessment_CCL_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k)	Form and Instruction
Form 0920-1453 Att 4j. Ex Assessment_CCL_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j)	Form and Instruction
Form 0920-1453 Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)	Form and Instruction
Form 0920-1453 Att 4f. Ex Assessment_TBC_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f)	Form and Instruction
Form 0920-1453 Att 4c. Ex Assessment_CQM_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c)	Form and Instruction
Form 0920-1453 Att 4b. Ex Assessment_CQM_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b)	Form and Instruction
Form 0920-1453 Att 3m. Eval Assessment_CCL_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m)	Form and Instruction
Form 0920-1453 Att 3l. Eval Assessment_CCL_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l)	Form and Instruction
Form 0920-1453 Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)	Form and Instruction
Form 0920-1453 Att 3h. Eval Assessment_TBC_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Att 3e. Eval Assessment_CQM_Recipient_Interview Guide_WW_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e)	Form and Instruction
Form 0920-1453 Att 3d. Eval Assessment_CQM_Recipient_Interview Guide_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d)	Form and Instruction
Form 0920-1453 Att 3b. Evaluability Assessment Nomination Form_WW_rev 2025	Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_WW (Attachment 3b)	Form and Instruction
Form 0920-1453 Att 3a. Evaluability Assessment Nomination Form_NCHP_ICHP_rev 2025	Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a)	Form and Instruction
Change Request Memo - Template NCCDPHP EPET Comp Eval 4_18_25.docx	Justification for No Material/Nonsubstantive Change
Change Request Memo - Template NCCDPHP EPET Comp Eval 4_18_25.docx	Justification for No Material/Nonsubstantive Change
SSB_VF_2025.04.29.docx	Supporting Statement B
SSB_VF_2025.04.29.docx	Supporting Statement B
SSA_VF_2025.04.29.docx	Supporting Statement A
SSA_VF_2025.04.29.docx	Supporting Statement A
Att 2c. 42 USC Section 241a.docx	Supplementary Document
Att 2c. 42 USC Section 241a.docx	Supplementary Document
Att 2f. FY 2023 Consolidated Appropriations Act.pdf	Supplementary Document
Att 2f. FY 2023 Consolidated Appropriations Act.pdf	Supplementary Document
Att 2e. 42 USC 300I.docx	Supplementary Document
Att 2e. 42 USC 300I.docx	Supplementary Document
Att 2d. 42 USC 300n-4a.docx	Supplementary Document
Att 2d. 42 USC 300n-4a.docx	Supplementary Document
Att 2b. 42 USC 300u-11.pdf	Supplementary Document
Att 2b. 42 USC 300u-11.pdf	Supplementary Document
Att 2a. 42 USC 247b.pdf	Supplementary Document
Att 2a. 42 USC 247b.pdf	Supplementary Document
Att 1c. CDC-RFA-DP-23-0003_Revised_Wisewoman.pdf	Supplementary Document
Att 1c. CDC-RFA-DP-23-0003_Revised_Wisewoman.pdf	Supplementary Document
Att 1b. CDC-RFA-DP-23-0005_Innovative.pdf	Supplementary Document
Att 1b. CDC-RFA-DP-23-0005_Innovative.pdf	Supplementary Document
Att 1a. CDC-RFA-DP-23-0004_National.pdf	Supplementary Document
Att 1a. CDC-RFA-DP-23-0004_National.pdf	Supplementary Document
Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a)	Form and Instruction
Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a)	Form and Instruction
Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)	Form and Instruction
Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)	Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b)	Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b)	Form and Instruction
Cost Study Interview Guide_Partner (Attachment 5d)	Form and Instruction
Cost Study Interview Guide_Partner (Attachment 5d)	Form and Instruction
Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m)	Form and Instruction
Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m)	Form and Instruction
Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l)	Form and Instruction
Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l)	Form and Instruction
Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i)	Form and Instruction
Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i)	Form and Instruction
Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h)	Form and Instruction
Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h)	Form and Instruction
Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e)	Form and Instruction
Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e)	Form and Instruction
Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d)	Form and Instruction
Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d)	Form and Instruction
Eval Assessment CCL Partner Interview Guide WW (Attachment 3o)	Form and Instruction
Eval Assessment CCL Partner Interview Guide WW (Attachment 3o)	Form and Instruction
Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n)	Form and Instruction
Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n)	Form and Instruction
Eval Assessment TBC Partner Interview Guide WW (Attachment 3k)	Form and Instruction
Eval Assessment TBC Partner Interview Guide WW (Attachment 3k)	Form and Instruction
Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j)	Form and Instruction
Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j)	Form and Instruction
Eval Assessment CQM Partner Interview Guide WW (Attachment 3g)	Form and Instruction
Eval Assessment CQM Partner Interview Guide WW (Attachment 3g)	Form and Instruction
Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f)	Form and Instruction
Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f)	Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a)	Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a)	Form and Instruction
Cost Study Interview Guide_Recipient (Attachment 5c)	Form and Instruction
Cost Study Interview Guide_Recipient (Attachment 5c)	Form and Instruction
Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k)	Form and Instruction
Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k)	Form and Instruction
Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j)	Form and Instruction
Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j)	Form and Instruction
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)	Form and Instruction
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)	Form and Instruction
Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f)	Form and Instruction
Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f)	Form and Instruction
Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c)	Form and Instruction
Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c)	Form and Instruction
Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b)	Form and Instruction
Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b)	Form and Instruction
Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m)	Form and Instruction
Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m)	Form and Instruction
Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l)	Form and Instruction
Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l)	Form and Instruction
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)	Form and Instruction
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)	Form and Instruction
Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h)	Form and Instruction
Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h)	Form and Instruction
Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e)	Form and Instruction
Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e)	Form and Instruction
Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d)	Form and Instruction
Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d)	Form and Instruction
Evaluability Assessment Nomination Form_WW (Attachment 3b)	Form and Instruction
Evaluability Assessment Nomination Form_WW (Attachment 3b)	Form and Instruction
Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a)	Form and Instruction
Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a)	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202504-0920-030	No material or nonsubstantive change to a currently approved collection	2025-05-01
202410-0920-005	New collection (Request for a new OMB Control Number)	2024-11-08		Approved without change

OMB Details

Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
Form	Name	Electronic access	Type
Form 0920-1453	Att 3a. Evaluability Assessment Nomination Form_NCHP_ICHP_rev 2025	N/A	Form and instruction

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