OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of the Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit

ICR 200711-0920-002 · OMB 0920-0764 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
0920-07AL_Supporting Statement_Sect B_10 22 07.doc Supporting Statement B Uploaded 2007-10-23 Available
0920-07AL_Attachment 6_0801.doc Supplementary Document Uploaded 2007-10-23 Repair queued
0920-07AL_Attachment 5_0801.doc Supplementary Document Uploaded 2007-10-23 Available
0920-07AL_Attachment 4_0801.doc Supplementary Document Uploaded 2007-10-23 Available
0920-07AL_Attachment 3_0801.doc Supplementary Document Uploaded 2007-10-23 Available
0920-07AL_Attachment 1_0801.doc Supplementary Document Uploaded 2007-10-23 Available
0920-07AL_Supporting Statement_Sect A_10 22 07.doc Supporting Statement A Uploaded 2007-10-23 Available
IC Document Collections
IC IDCollectionTypeStatusForm
182609 Evaluation of the Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit Other-Data Collection Instrument New
ICR Details
0920-0764 200711-0920-002
Historical Active
HHS/CDC
Evaluation of the Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/15/2008
Retrieve Notice of Action (NOA) 11/06/2007
  Inventory as of this Action Requested Previously Approved
02/28/2009 12 Months From Approved
25 0 0
13 0 0
0 0 0
This project builds on previous work with CDC to develop a Business Toolkit for State Health Departments(SHDs) to use in their work with employers. The Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit was designed to be used by the SHDs in their efforts with employers implementing worksite cardiovascular health promotion programs and purchasing preventive health benefits from health plans. For this project, we have trained SHDs to use the Toolkit, provided consultation services, and are evaluating the Toolkit's usefulness from the perspectives of the SHDs and employers. This data collection request is for to survey a representative of each SHD and the District of Columbia from the Heart Disease and Stroke Prevention program. The information gathered will be used to modify and improve the Toolkit and make it more useful for State Health Departments in their work with employers.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  72 FR 4512 01/31/2007
72 FR 50371 08/31/2007
No
1
IC Title Form No. Form Name
Evaluation of the Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
  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 25 0 0 25 0 0
Annual Time Burden (Hours) 13 0 0 13 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$18,842
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Maryam Daneshvar 4046394604
  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.
11/06/2007