OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Survey of Illness and Injury Among Backcountry Users in Yellowstone National Park

ICR 200706-0920-011 · OMB 0920-0727 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Consent to Further Contact Form and Instruction Modified Available
Yellowstone National Park Backcountry Survey [Paper Version] Form and Instruction New Available
Yellowstone National Park Backcountry Survey [Web-based Version] Form and Instruction New Available
Yellowstone Backcountry Study OMB Protocol Revision_082307_B.doc Supplementary Document Uploaded 2007-08-23 Available
YBS Supporting Statement B 060707.doc Supporting Statement B Uploaded 2007-06-12 Available
Appendix R_CDC Study Website_060607.doc Supplementary Document Uploaded 2007-06-13 Available
Appendix Q_NPS Study Website_060607.doc Supplementary Document Uploaded 2007-06-13 Available
Appendix J_IRB Exemption Determination_060707.pdf Supplementary Document Uploaded 2007-06-13 Repair queued
Appendix I_60-Day Federal Register Notice_060707.pdf Supplementary Document Uploaded 2007-06-12 Available
Appendix E_SEKI Refusal Log_083006.doc Supplementary Document Uploaded 2007-06-12 Available
Appendix D_SEKI Consent-to-Further-Contact Form_060707.pdf Supplementary Document Uploaded 2007-06-12 Available
Appendix C_SEKI Pilot Study Methodology_060607.doc Supplementary Document Uploaded 2007-06-12 Available
Appendix B_US Code Title 42 Public Health and Welfare.doc Supplementary Document Uploaded 2007-06-12 Available
Appendix A_NPS Directors Order 83.doc Supplementary Document Uploaded 2007-06-12 Available
YBS Supporting Statement A 060707.doc Supporting Statement A Uploaded 2007-06-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
43617 Consent to Further Contact Form and Instruction Modified
180718 Yellowstone National Park Backcountry Survey [Paper Version] Form and Instruction New
180717 Yellowstone National Park Backcountry Survey [Web-based Version] Form and Instruction New
ICR Details
0920-0727 200706-0920-011
Historical Active 200604-0920-002
HHS/CDC
Survey of Illness and Injury Among Backcountry Users in Yellowstone National Park
Revision of a currently approved collection   No
Regular
Approved with change 08/23/2007
Retrieve Notice of Action (NOA) 06/13/2007
Approved consistent with revisions to the proposed survey methodology layed out in CDC memo submitted to OMB.
  Inventory as of this Action Requested Previously Approved
01/31/2009 12/31/2008 08/31/2007
13,670 0 5,276
2,141 0 1,803
0 0 0
CDC is collaborating with the National Park Service to conduct a public health survey designed to gather informaion to improve recommendations for safe and healthy backcountry travel. The survey will be conducted among Yellowstone National Park hikers regarding illness and injuries experienced while in the back country.
US Code: 42 USC 241 Name of Law: Pubilc Health Service Act
  
None
Not associated with rulemaking
  70 FR 62121 10/28/2005
72 FR 32669 06/13/2007
No
  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 13,670 5,276 0 8,394 0 0
Annual Time Burden (Hours) 2,141 1,803 0 338 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
This Revision includes 1) a report on a preliminary pilot study conducted at the Sequoia and Kings Canyon National Parks [data collection in Fall 2006], and 2) plans for an expanded study to be conducted at Yellowstone National Park [data collection May-Dec 2008]. For the proposed expanded study, burden estimates for the primary data collection instrument (web and paper versions) have been increased as a result of experience gained in the pilot phase. However, the estimated burden for the initial contact form has been reduced due to a proposed reduction in the number of demographic elements. For additional information, please refer to the NOA dated September 19, 2006.
$70,365
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman
  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.
06/13/2007