Information Collection Request

National Quitline Data Warehouse

ICR 201006-0920-002 · OMB 0920-0856 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Quitline Services Questionnaire Form New Repair queued
Follow-up for Callers who Received a Quitline Service Form New Available
Intake Information for Callers who Contact the Quitline for Personal Use Form New Available
Intake Information for Callers who Contact the Quitline for Someone Else Form New Available
NQDW SS Part B 05-04-10.docx Supporting Statement B Uploaded 2010-05-17 Available
NCCDPHP 684 Non-Research Determination 0920-10BT.xps Supplementary Document Uploaded 2010-05-17 Repair queued
H. Sample Table Shells.docx Supplementary Document Uploaded 2010-05-17 Available
D. Consultants.docx Supplementary Document Uploaded 2010-05-17 Available
C. Summary of Public Comments.doc Supplementary Document Uploaded 2010-05-17 Available
B. Federal Register Notice.pdf Supplementary Document Uploaded 2010-05-17 Available
A2. Public Health Service Act.doc Supplementary Document Uploaded 2010-05-17 Available
A1. ARRA of 2009.pdf Supplementary Document Uploaded 2010-05-17 Available
G3. Reminder Email for Services Questionnaire.docx Supplementary Document Uploaded 2010-05-17 Repair queued
G2. Advance Email for Services Questionnaire.docx Supplementary Document Uploaded 2010-05-17 Repair queued
F2. NQDW Advance Letter for Folllow-up.doc Supplementary Document Uploaded 2010-05-17 Repair queued
NQDW SS Part A 05-13-10.doc Supporting Statement A Uploaded 2010-05-17 Available
ICR Details
0920-0856 201006-0920-002
Historical Active
HHS/CDC
National Quitline Data Warehouse
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/12/2010
Retrieve Notice of Action (NOA) 06/01/2010
  Inventory as of this Action Requested Previously Approved
07/31/2012 24 Months From Approved
759,112 0 0
90,563 0 0
0 0 0

CDC will collect newly standardized information from Quitline service providers in 50 states, DC, Puerto Rico and Guam. Data about each program will be collected, as well as caller intake and follow-up data. Information will be used for program improvement and to evaluate the expenditure of funding provided by the ARRA of 2009.

PL: Pub.L. 111 - 5 1 Name of Law: American Recovery and Reinvestment Act of 2009
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  75 FR 9224 03/01/2010
75 FR 28620 05/21/2010
Yes

  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 759,112 0 0 759,112 0 0
Annual Time Burden (Hours) 90,563 0 0 90,563 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new one-time ICR necessary for the improvement and evaluation of the National Tobacco Control Program. Information also will be used to assist in the evaluation of funding provided by the ARRA of 2009.

$3,125,962
Yes Part B of Supporting Statement
Yes
No
Uncollected
Yes
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.
06/01/2010