OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Formative Research for and Community Uptake of the Eagle Books and Youth Books for American Indians and Alaska Natives

ICR 201107-0920-005 · OMB 0920-0897 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Interview with Middle Schoolers Form New Repair queued
Interview with Children Grades 2-4 Form New Available
Interview with Children K-1 Form New Available
Interview with Parents Form New Available
Interview with Teachers Form New Repair queued
Interview with School Administrators Form New Available
Interview with Community Representatives Form New Repair queued
Local Scheduling Worksheet Form New Available
SS Part B July 18 2011.doc Supporting Statement B Uploaded 2011-07-20 Available
L Eagle Books Observation List.docx Supplementary Document Uploaded 2011-07-20 Available
J IRB Approval rpt684_IRB_Form.pdf Supplementary Document Uploaded 2011-07-20 Available
Att B-2. Summary of Public Comments.doc Supplementary Document Uploaded 2011-07-20 Available
B-1 60-day FRN 02.11.2011.pdf Supplementary Document Uploaded 2011-07-20 Available
A-2 Authorizing Legislation WIC.pdf Supplementary Document Uploaded 2011-07-20 Available
A-1 Authorizing Legislation PHSA.pdf Supplementary Document Uploaded 2011-07-20 Available
I-4 Middle Schooler Youth Assent Form.doc Supplementary Document Uploaded 2011-07-20 Available
I-3 Middle Schooler Parental Consent.doc Supplementary Document Uploaded 2011-07-20 Available
I-2 Middle Schoolers Parent Information Sheet.doc Supplementary Document Uploaded 2011-07-20 Available
H-3 Children Grades K-4 Youth Assent Form.doc Supplementary Document Uploaded 2011-07-20 Available
H-2 Children Grades K-4 Parental Consent Form.doc Supplementary Document Uploaded 2011-07-20 Available
G-3 Children Grades K-4 Youth Assent Form.doc Supplementary Document Uploaded 2011-07-20 Available
G-2 Children Grades K-4 Parental Consent Form.doc Supplementary Document Uploaded 2011-07-20 Available
F-3 Parents Consent form.doc Supplementary Document Uploaded 2011-07-20 Available
F-2 Parents Information Sheet.doc Supplementary Document Uploaded 2011-07-20 Repair queued
E-3 Teachers Consent Form.doc Supplementary Document Uploaded 2011-07-20 Source copy available
E-2 Teachers Information Sheet.doc Supplementary Document Uploaded 2011-07-20 Repair queued
D-3 School Admin Consent Form.doc Supplementary Document Uploaded 2011-07-20 Repair queued
D-2 School Admin Information Sheet.doc Supplementary Document Uploaded 2011-07-20 Available
C-2 Comm Rep Information Sheet.doc Supplementary Document Uploaded 2011-07-20 Available
C-3 Comm Rep Consent Form.doc Supplementary Document Uploaded 2011-07-20 Available
SS Part A July 19 2011.doc Supporting Statement A Uploaded 2011-07-20 Available
IC Document Collections
IC IDCollectionTypeStatusForm
198630 Interview with Middle Schoolers Form New
198629 Interview with Children Grades 2-4 Form New
198628 Interview with Children K-1 Form New
198627 Interview with Parents Form New
198626 Interview with Teachers Form New
198625 Interview with School Administrators Form New
198624 Interview with Community Representatives Form New
198623 Local Scheduling Worksheet Form New
ICR Details
0920-0897 201107-0920-005
Historical Active
HHS/CDC
Formative Research for and Community Uptake of the Eagle Books and Youth Books for American Indians and Alaska Natives
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/12/2011
Retrieve Notice of Action (NOA) 07/25/2011
Approved consistent with the understanding that the collection is not intended to be an "impact" (outcome) evaluation of changes attributable to the books. Rather, this is a formative researach study.
  Inventory as of this Action Requested Previously Approved
08/31/2013 24 Months From Approved
108 0 0
112 0 0
0 0 0
CDC's Native Diabetes Wellness Program requests OMB approval to conduct formative research to assess uptake of, receptivity, satisfaction with, and influence of the Eagle Books and Youth Eagle Books.
PL: Pub.L. 108 - 265 204 Name of Law: Child Nutrition and WIC Reauthorization
   US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  76 FR 7856 02/11/2011
76 FR 21747 04/18/2011
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 108 0 0 108 0 0
Annual Time Burden (Hours) 112 0 0 112 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a resubmission of the previously submitted ICR titled "Development and Evaluation of Eagle Books and Youth Eagle Books for American Indians and Alaska Natives" that was withdrawn by OMB. OMB waived the republication of a 30 day FRN.
$227,697
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Daniel Holcomb 770 488-4472 [email protected]
  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.
07/25/2011