OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring Outcomes of the Enhanced Comprehensive HIV Prevention Plan (ECHPP) Project

ICR 201112-0920-015 · OMB 0920-0922 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
SEES_Participant Recruitment Protocol.docx Supplementary Document Uploaded 2012-02-15 Available
SEES_Data Management Plan.docx Supplementary Document Uploaded 2012-02-15 Available
SEES_Data Collection Protocol.docx Supplementary Document Uploaded 2012-02-15 Available
Rev Supporting Statement B - ECHPP[1].doc Supporting Statement B Uploaded 2012-02-14 Source copy available
Attach 10 Consultant List.docx Supplementary Document Uploaded 2011-12-20 Available
Attachment 6d Contractor Pledge Form for 308d Confidentiality.docx Supplementary Document Uploaded 2011-12-20 Repair queued
Rev Attachment 6c_Contractor Pledge Form for 308d Confidentiality.docx Supplementary Document Uploaded 2012-02-15 Available
Rev Attachment 6b_Rules of Behavior for CDC Staff and Contractors.doc Supplementary Document Uploaded 2012-02-15 Repair queued
Rev Attachment 6a_Guidelines_for_HIV_AIDS_Surveillance.pdf Supplementary Document Uploaded 2012-02-15 Available
Attachment 5b Clinic Survey Consent Script.docx Supplementary Document Uploaded 2011-12-20 Available
Attachment 5a Community Survey Consent Script.docx Supplementary Document Uploaded 2011-12-20 Repair queued
Attachment 4 Information Sheet.doc Supplementary Document Uploaded 2011-12-20 Repair queued
Attach 1a_Public Health Service Act 301.docx Supplementary Document Uploaded 2011-12-20 Available
Attach 1b_Public Health Service Act 308.docx Supplementary Document Uploaded 2011-12-20 Available
Attach 7b _Venue Owner_Manager Script.doc Supplementary Document Uploaded 2012-02-15 Available
Attach 7a _Clinic Director Script.doc Supplementary Document Uploaded 2011-12-20 Available
Rev Attach 9b Clinic Survey Interviewer Script.docx Supplementary Document Uploaded 2012-02-15 Available
Rev Supporting Statement A - ECHPP1.docx Supporting Statement A Uploaded 2012-02-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
200569 Community Survey - Eligible High-Risk Heterosexual Individuals Instruction New
200568 Community Survey - Eligible Injection Drug Users Instruction New
200567 Community Screener - Screened Injection Drug Users and High-risk heterosexual individuals Instruction New
200566 Clinic Survey - Eligible HIV-positive Individuals Instruction New
200565 Clinic Screener - HIV Positive Screened Individuals Instruction New
200564 Clinic Staff Script - Approaching Clients Instruction New
200563 Clinic Staff Provision Patient of Loads Instruction New
200562 Project Orientation - Clinic Staff Instruction New
ICR Details
0920-0922 201112-0920-015
Historical Active
HHS/CDC
Monitoring Outcomes of the Enhanced Comprehensive HIV Prevention Plan (ECHPP) Project
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 02/15/2012
Retrieve Notice of Action (NOA) 12/21/2011
CDC understands that the limitations in the study design must be discussed whenever results of this collection are presented.
  Inventory as of this Action Requested Previously Approved
02/28/2015 36 Months From Approved
7,040 0 0
1,704 0 0
0 0 0
This data collection activity will assist with the ECHPP evaluation. This data collection activity will occur in six of the 12 ECHPP MSAs. This activity is designed to monitor community-level outcomes of ECHPP in these MSAs and supplement existing HIV surveillance data that are already being collected via CDC data systems in these cities.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  76 FR 18554 04/04/2011
76 FR 78924 12/20/2011
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 7,040 0 0 7,040 0 0
Annual Time Burden (Hours) 1,704 0 0 1,704 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection
$3,633,362
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Catina Conner 4046394775
  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.
12/21/2011