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Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluating the Effectiveness of the Asthma Intervention Program, Power Breathing

ICR 200309-0920-005 · OMB 0920-0609 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7074 Evaluating the Effectiveness of the Asthma Intervention Program, Power Breathing Migrated
ICR Details
0920-0609 200309-0920-005
Historical Active
HHS/CDC
Evaluating the Effectiveness of the Asthma Intervention Program, Power Breathing
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 12/18/2003
Retrieve Notice of Action (NOA) 09/30/2003
  Inventory as of this Action Requested Previously Approved
12/31/2004 12/31/2004
1,100 0 0
1,024 0 0
0 0 0
An evaluation of the effectiveness of an adolescent asthma intervention program will be conducted among middle and high school students with asthma in two school districts. Mixed-mode data collection methods will be used to gather quantitative and qualitative information from students, parents, program facilitators, and school staff. A quasi-experimental design will be utilized, involving matched-comparison schools and pre-/post-intervention data collection. Analysis will focus on process, outcome, cost, and knowledge/attitude/behavior data.
None
None
No
1
IC Title Form No. Form Name
Evaluating the Effectiveness of the Asthma Intervention Program, Power Breathing
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,100 0 0 1,100 0 0
Annual Time Burden (Hours) 1,024 0 0 1,024 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/30/2003