OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Cost and Follow-up Assessment of Administration on Aging (AoA) - Funded Fall Prevention Programs for Older Adults

ICR 201003-0920-004 · OMB 0920-0818 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Cost and Follow-up Assessment of Fall Prevention Programs Form Modified Repair queued
Follow-up Assessment of Matter of Balance Programs Form Modified Available
Screener for Follow-up Assessment of Matter of Balance Programs Form Modified Available
Supporting_Statement_Part_B_1 27 10.doc Supporting Statement B Uploaded 2010-02-10 Available
FedRegister_9-4-09.pdf Supplementary Document Uploaded 2010-03-01 Repair queued
CONSENT FORM 0920-0818 MOB-CDC 02-2010.doc Supplementary Document Uploaded 2010-02-10 Available
Attachment_5__Cost_and_Foll_UpPrevention_determination.pdf Supplementary Document Uploaded 2010-02-10 Available
Prelim_sampling_plan.pdf Supplementary Document Uploaded 2010-02-10 Repair queued
Attachment_4_Federal_Register_notice_4-14-08.pdf Supplementary Document Uploaded 2010-02-10 Repair queued
Attachment_1-_Authorizing_Legislation_12_01.doc Supplementary Document Uploaded 2010-02-10 Available
Supporting_Statement_Part_A_Extension02.24.10.docx Supporting Statement A Uploaded 2010-02-25 Available
IC Document Collections
IC IDCollectionTypeStatusForm
188659 Cost and Follow-up Assessment of Fall Prevention Programs Form Modified
188658 Follow-up Assessment of Matter of Balance Programs Form Modified
188657 Screener for Follow-up Assessment of Matter of Balance Programs Form Modified
ICR Details
0920-0818 201003-0920-004
Historical Active 200904-0920-002
HHS/CDC
Cost and Follow-up Assessment of Administration on Aging (AoA) - Funded Fall Prevention Programs for Older Adults
Extension without change of a currently approved collection   No
Regular
Approved without change 04/05/2010
Retrieve Notice of Action (NOA) 03/10/2010
CDC acknowledges that the case study design of the evaluation component limits generalizability of findings to broader populations. While the evaluation case study is likely to yield interesting results, it cannot be used to determine the overall effectiveness of the "Matter of Balance" program.
  Inventory as of this Action Requested Previously Approved
04/30/2013 36 Months From Approved 07/31/2010
375 0 1,125
247 0 744
0 0 0
CDC requests a 3 year extension to collect data for the Cost and Follow-up Assessment of Fall Prevention Programs. CDC seeks to examine the cost of implementing each of three Administration on Aging-Funded Fall Prevention Programs for older adults - Stepping On, Moving for Better Balance and Matter of Balance, and the extent to which preventive behaviors are maintained. CDC initially assessed these programs in one year, and requests an extension to continue assessment over 3 years.
US Code: 42 USC 301 Name of Law: Public Health Services Act
  
None
Not associated with rulemaking
  74 FR 45861 09/04/2009
75 FR 6671 02/10/2010
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 375 1,125 0 0 -750 0
Annual Time Burden (Hours) 247 744 0 0 -497 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$131,343
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
No
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.
03/10/2010