OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Case Studies of Selected Communities and States Funded under Community Activities under the Communities Putting Prevention to Work (CPPW) Initiative

ICR 201010-0920-010 · OMB 0920-0876 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Policy and Decision Makers Interview, Private Sector Form New Available
Policy and Decision Makers Interview, State and Local Government Sector Form New Available
Community Partners Interview, Private Sector Form New Available
Community Partners Interview, State and Local Government Sector Form New Available
Interview Planning Worksheet Form New Repair queued
CPPW Staff Interview Form New Available
CPPW Management Interview Form New Available
Interview Planning Tool Form New Available
Table Summary of CPPW Evaluation 01 06 2011.doc Supplementary Document Uploaded 2011-01-06 Available
CPPW Case Study SS Part B_FINAL 01 06 2011.docx Supporting Statement B Uploaded 2011-01-06 Available
Attachment 1c ACA PL 111-148 Section 4002.pdf Supplementary Document Uploaded 2010-10-28 Available
Attachment 14 Candidate communities.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 13 Oral Informed Consent Script.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 12 RTI CPPW Case Study Non-Disclosure Agreement.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 6 ARRA-Funded CPPW States, Territories and the District of Columbia.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 5 MAPPS Strategies and References.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 4 Affordable Care Act Funded Communities.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 3 ARRA Funded CPPW Communities.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 2b Summary of Public Comments.doc Supplementary Document Uploaded 2010-10-22 Repair queued
Attachment 2a Federal Register Notice.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 1b ARRA of 2009.pdf Supplementary Document Uploaded 2010-10-22 Available
Attachment 1a. Public Health Service Act.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 7e Site Visit Preparatory Call.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 7d Introductory e-mail to schedule site visit preparatory call.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 7b CPPW Case Study Introductory Letter.doc Supplementary Document Uploaded 2010-10-22 Available
Attachment 7c Case Study FAQs for CPPW-Affordable Care Act Sites.doc Supplementary Document Uploaded 2010-10-22 Available
CPPW Case Study SS Part A_FINAL 01 06 2011.doc Supporting Statement A Uploaded 2011-01-06 Available
IC Document Collections
IC IDCollectionTypeStatusForm
195057 Policy and Decision Makers Interview, Private Sector Form New
195056 Policy and Decision Makers Interview, State and Local Government Sector Form New
195055 Community Partners Interview, Private Sector Form New
195054 Community Partners Interview, State and Local Government Sector Form New
195053 Interview Planning Worksheet Form New
195052 CPPW Staff Interview Form New
195051 CPPW Management Interview Form New
195050 Interview Planning Tool Form New
ICR Details
0920-0876 201010-0920-010
Historical Active
HHS/CDC
Case Studies of Selected Communities and States Funded under Community Activities under the Communities Putting Prevention to Work (CPPW) Initiative
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/17/2011
Retrieve Notice of Action (NOA) 10/29/2010
  Inventory as of this Action Requested Previously Approved
01/31/2013 24 Months From Approved
528 0 0
678 0 0
0 0 0
CDC proposes to conduct case studies of selected CPPW states and communities to gain insight into the factors that facilitate or hinder the implementation of MAPPS strategies for improving nutrition and physical activity, and decreasing the prevalence of obesity and tobacco use. Information will be collected at personal interviews conducted at each case study site.
PL: Pub.L. 111 - 5 VIII Name of Law: American Recovery and Reinvestment Act of 2009
   US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 148 4002 Name of Law: Patient Protection and Affordable Care Act
  
None
Not associated with rulemaking
  75 FR 11184 03/10/2010
75 FR 65355 10/22/2010
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 528 0 0 528 0 0
Annual Time Burden (Hours) 678 0 0 678 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection required as part of a comprehensive evaluation of Communities Putting Prevention to Work, a ARRA funded initiative.
$1,571,528
Yes Part B of Supporting Statement
Yes
Yes
No
Yes
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.
10/29/2010