OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Assessing the Diabetes Detection Initiative for Policy Decisions

ICR 200802-0920-006 · OMB 0920-0791 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form No number DDI Patient Survey Form New Available
Form No number Screening Questions for the DDI Patient Survey Form New Available
Form No number DDI Health Leadership Clinic Survey Form New Available
Supporting Statement B.doc Supporting Statement B Uploaded 2008-01-16 Available
Attachment E Methodology for Conducting Perceived Benefits Analysis.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment D Battelle IRB approval.pdf Supplementary Document Uploaded 2008-01-16 Available
Attachment C CDC IRB approval.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment B 60-day FRN.pdf Supplementary Document Uploaded 2008-01-16 Available
Attachment A Authorizing Legislation.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment G.5 FAQ for the DDI Patient Survey.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment G.4 Patient Consent.doc Supplementary Document Uploaded 2008-01-16 Repair queued
Attachment G.2 Stated Preferences Module.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment F.4 Thank you.doc Supplementary Document Uploaded 2008-01-16 Repair queued
Attachment F.2 Cover letter for DDI Health Clinic leadership survey.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment F.1 Advance -email message to clinic leadership survey.doc Supplementary Document Uploaded 2008-01-16 Available
Attachment F.3 1st and 2nd e-mail reminder messages for the clinic leadership survey.doc Supplementary Document Uploaded 2008-01-16 Available
Supporting Statement A.doc Supporting Statement A Uploaded 2008-01-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
183711 DDI Patient Survey Form New
183710 Screening Questions for the DDI Patient Survey Form New
183709 DDI Health Leadership Clinic Survey Form New
ICR Details
0920-0791 200802-0920-006
Historical Active
HHS/CDC
Assessing the Diabetes Detection Initiative for Policy Decisions
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/05/2008
Retrieve Notice of Action (NOA) 02/06/2008
Approved consistent with the following terms of clearance: OMB approves the proposed survey for purposes of gathering initial limited information regarding the diabetes detection pilot, upon completion of the survey CDC will provide OMB with a report detailing results, survey results will not be characterized as generalizable outside the survey areas/populations queried; additionally, given the limited scope of the pilot (10 sites) CDC will not rely solely or primarily on survey results generated from this collection to inform broader policy decisions related to diabetes.
  Inventory as of this Action Requested Previously Approved
09/30/2009 12 Months From Approved
1,630 0 0
263 0 0
0 0 0
CDC plans to conduct two related economic assessments of diabetes screening and outreach programs at clinics that participated in the Diabetes Detection Initiative, a national pilot program that was implemented at 10 locations across the United States. The results of the economic assessments will be critical for making a number of public health policy decisions related to screening for undiagnosed diabetes.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  72 FR 8737 02/27/2007
73 FR 3977 01/23/2008
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 1,630 0 0 1,630 0 0
Annual Time Burden (Hours) 263 0 0 263 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$176,628
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Carol Walker 4046394773
  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.
02/06/2008