OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Well-Integrated Screening and Evaluation for Women Across the Nation(WISEWOMAN) Reporting System

ICR 201101-0920-002 · OMB 0920-0612 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
0920-0612_ChangeRequest_01242011.doc Justification for No Material/Nonsubstantive Change Uploaded 2011-01-28 Available
0920-0612_ChangeRequest_12222010.docx Justification for No Material/Nonsubstantive Change Uploaded 2010-12-23 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
37802 Screening and Assessment Minimum Data Elements (MDEs) Instruction Modified
191867 Progress Report Instruction Modified
191866 Intervention Minimum Data Elements (MDEs) Instruction Modified
ICR Details
0920-0612 201101-0920-002
Historical Active 201001-0920-007
HHS/CDC
Well-Integrated Screening and Evaluation for Women Across the Nation(WISEWOMAN) Reporting System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 01/31/2011
Retrieve Notice of Action (NOA) 01/18/2011
  Inventory as of this Action Requested Previously Approved
03/31/2013 03/31/2013 03/31/2013
126 0 126
1,680 0 1,680
0 0 0
CDC requests OMB approval to implement minor changes to the Screening and Assessment MDE and the Intervention MDE. No changes to the Progress Report are proposed. The program scope, purpose, burden, protocol, methodology, and planned analyses remain unchanged from the previous approval. The purpose of the WISEWOMAN program is to reduce cardiovascular disease (CVD) risk factors among at-risk women. CDC collects evaluation information from grantees semi-annually, including data about the risk factors of women served, the interventions in which they participated, and program cost and progress information. The women served through the WISEWOMAN program also participate in the National Breast and Cervical Cancer Early Detection Program.
PL: Pub.L. 101 - 354 300n-4a Name of Law: The Breast and Cervical Cancer Mortality Prevention Act of 1990
   US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
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 126 126 0 0 0 0
Annual Time Burden (Hours) 1,680 1,680 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$329,706
No
Yes
No
No
No
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.
01/18/2011