OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Community Transformation Grants: Evaluation of Nutrition, Physical Activity, and Obesity-related Television Media Campaigns

ICR 201210-0920-013 · OMB 0920-0967 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Health and Media Survey Form and Instruction New Repair queued
Welcome to the Health and Media Survey Form and Instruction New Available
ICR.0920-12LR-CTG. Media Campaigns. Part B.CLEAN.docx Supporting Statement B Uploaded 2013-05-13 Available
Attachment 9_IRB Approval.pdf Supplementary Document Uploaded 2012-10-29 Available
Attachment 7_RN Recruitment Procedures.docx Supplementary Document Uploaded 2012-10-29 Repair queued
Attachment 4_CTG Awardees.docx Supplementary Document Uploaded 2012-10-29 Available
Attachment 3_Strategic Directions.docx Supplementary Document Uploaded 2012-10-29 Available
Attachment 1d_PPHF.pdf Supplementary Document Uploaded 2012-10-29 Available
Attachment 1c_ACA.pdf Supplementary Document Uploaded 2012-10-29 Available
Attachment 1b_ARRA.pdf Supplementary Document Uploaded 2012-10-29 Available
Attachment 1a_PHSA.pdf Supplementary Document Uploaded 2012-10-29 Available
Attachment 8_Email Notification and Reminders.docx Supplementary Document Uploaded 2012-10-29 Available
ICR. 0920-12LR-CTG. Media Campaigns.Part A.CLEAN.docx Supporting Statement A Uploaded 2013-05-13 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
204661 Health and Media Survey Form and Instruction New
204660 Welcome to the Health and Media Survey Form and Instruction New
ICR Details
0920-0967 201210-0920-013
Historical Active
HHS/CDC
Community Transformation Grants: Evaluation of Nutrition, Physical Activity, and Obesity-related Television Media Campaigns
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 05/13/2013
Retrieve Notice of Action (NOA) 10/31/2012
  Inventory as of this Action Requested Previously Approved
05/31/2014 12 Months From Approved
41,064 0 0
8,983 0 0
0 0 0
CDC plans to conduct a web-based survey to evaluate nutrition, physical activity, and obesity related campaigns conducted as part of CDC's Community Transformation Grant program. The cross-sectional survey will be administered in areas where CTG awardees are conducting media campaigns and in two comparison samples.
US Code: 42 USC 241 Name of Law: Research and Investigations Generally
  
None
Not associated with rulemaking
  77 FR 33462 06/06/2012
77 FR 65191 10/25/2012
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 41,064 0 0 41,064 0 0
Annual Time Burden (Hours) 8,983 0 0 8,983 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is new information collection necessary to support evaluation of ACA and ARRA funded activities.
$573,056
Yes Part B of Supporting Statement
Yes
Yes
No
Yes
Uncollected
Petunia Gissendaner 4046390164
  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.
10/31/2012