OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ICR 201402-0920-015 · OMB 0920-0956 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Testing GovDelivery Form New Available
CDC Digital Health Tools Evaluation Form New Available
CDC Spanish Homepage Survey Form New Repair queued
CDC Flu Site - Card Sort Form New Repair queued
CDC Homepage Post-launch Survey Form New Available
Testing Clear Communication Index Website Form Modified Repair queued
CDC Homepage UX Form Modified Available
Testing of Sample Materials Developed Using the CDC Clear Communications Index Form and Instruction Modified Repair queued
CDC Homepage Mobile & Desktop Survey Form Modified Repair queued
Solve the Outbreak iPad Survey Form Modified Repair queued
Vital Signs Survey Form and Instruction Modified Repair queued
change for 0920-0956.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-02-20 Available
Att.B_9-Before-Policymakers-Budget.pdf Supplementary Document Uploaded 2014-02-20 Available
Att.B_2-After-Clinicians-Flu.pdf Supplementary Document Uploaded 2014-02-20 Available
GenIC_Index Web Survey.corrected.docx Supplementary Document Uploaded 2014-02-12 Repair queued
Att.L Recruitment Materials.docx Supplementary Document Uploaded 2014-02-12 Available
Att.B_16-After-Health-Departments-NVDRS.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_15-Before-HealthDept-NVDRS_2013.12.12.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_14 -After-Health-Departments-MAHC.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_13-Before-Health-Departments-MAHC.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_12- After-Policymakers-Epidemiology.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_11-Before-Policymakers-Epidemiology.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_10-After-Policymakers-Budget.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_8-After-Partners-Heart-Disease.pdf Supplementary Document Uploaded 2014-02-12 Repair queued
Att.B_7- Before-Partners-Heart-Disease.png Supplementary Document Uploaded 2014-02-12 Repair queued
Att.B_6-After-Partners-HAI.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_5- Before-Partners-HAI.png Supplementary Document Uploaded 2014-02-12 Available
Att.B_4- After-Clinicians-Wisconsin.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_3-Before-Clinicians-Wisconsin.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.B_1-Before-Clinicians-Flu.pdf Supplementary Document Uploaded 2014-02-12 Available
Att.A-Web Survey Protocol.docx Supplementary Document Uploaded 2014-02-12 Available
E-Scenarios -CDC_STOapplication_UX_01_07_2014 - OMB.docx Supplementary Document Uploaded 2014-01-10 Available
C-Consent Forms -CDC_STOapplication_UX_01_07_2014 - OMB.docx Supplementary Document Uploaded 2014-01-10 Available
B-Instructions -CDC_STOapplication_UX_01_07_2014 - OMB.docx Supplementary Document Uploaded 2014-01-10 Available
A-Protocal -CDC_STOapplication_UX_01_07_2014 - OMB.docx Supplementary Document Uploaded 2014-01-10 Repair queued
fast-track-PRA-submission-short-form-cdc_Solve the Outbreak iPad Usability Protocol_01_07_2014.docx Supplementary Document Uploaded 2014-01-10 Available
D-Scenarios -CDChomepageUX121613 - OMB.docx Supplementary Document Uploaded 2013-12-16 Available
C-Consent Forms -CDChomepageUX121013 - OMB.docx Supplementary Document Uploaded 2013-12-16 Repair queued
B - Instructions -CDChomepageUX121613 - OMB.docx Supplementary Document Uploaded 2013-12-16 Available
A-PROTOCOL-CDChomepageUX121013.docx Supplementary Document Uploaded 2013-12-16 Available
fast-track-PRA-submission-short-form-cdc-CDChomepageUX121613.docx Supplementary Document Uploaded 2013-12-16 Available
Attachment1_CDC-Index-Click-testing-Protocol_2013.11.07.docx Supplementary Document Uploaded 2013-11-20 Available
List of Attachments for Testing of Sample Materials Developed Using the CDC Clear Communications Index.docx Supplementary Document Uploaded 2013-11-20 Available
GenIC_Index Click Test 2013.11.06.docx Supplementary Document Uploaded 2013-11-20 Repair queued
fast-track-PRA-submission-short-form-cdc homepage mobile desktop.doc Supplementary Document Uploaded 2013-09-04 Available
Solve the Outbreak User Zoom Questions.docx Supplementary Document Uploaded 2013-06-26 Available
Surveytemplate _SolvetheOutbreak.docx Supplementary Document Uploaded 2013-06-26 Available
Survey1template _VitalSignsv2.docx Supplementary Document Uploaded 2013-06-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
214226 Testing GovDelivery Form New
213571 CDC Digital Health Tools Evaluation Form New
212305 Solve the Outbreak Mobile App Survey Other-WORD New
212251 CDC Spanish Homepage Survey Form New
212040 CDC Social Media Satisfaction Survey Other-WORD New
211673 CDC Flu Site - Card Sort Form New
211632 CDC Homepage UX -- After Release Other-WORD New
211032 CDC Homepage Post-launch Survey Form New
210376 Testing Clear Communication Index Website Form Modified
210038 Solve the Outbreak (14GM) Other-Screenshots Modified
209701 CDC Homepage UX Form Modified
209487 Testing of Sample Materials Developed Using the CDC Clear Communications Index Form and Instruction Modified
208545 CDC Homepage Mobile & Desktop Survey Form Modified
207575 Solve the Outbreak iPad Survey Form Modified
207398 Vital Signs Survey Form and Instruction Modified
ICR Details
0920-0956 201402-0920-015
Historical Active 201303-0920-011
HHS/CDC 21469
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 02/27/2014
Retrieve Notice of Action (NOA) 02/25/2014
Previous terms continue: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.¿
  Inventory as of this Action Requested Previously Approved
03/31/2016 03/31/2016 03/31/2016
30,750 0 10,250
15,750 0 5,250
0 0 0
This request for nonsubstantive change is to correct an error made by CDC when the generic ICR was submitted. The number of responses and burden hours were entered for one year of information collection, and should have been tripled to account for the 3 years of clearance.
US Code: 42 USC 41 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
No
15
IC Title Form No. Form Name
CDC Digital Health Tools Evaluation none, none CDC Digital Health Tools Survey ,   CDC Digital Health Tools Survey - word
CDC Flu Site - Card Sort none Card Sort Screenshots
Testing Clear Communication Index Website none Survey
Testing GovDelivery none, none, none, none, none, none, none, none, none, none, none, none, none, none, none Survey ,   Flu vaccine - screenshots - A ,   Flu vaccine - screenshots - B ,   Mental Health among Women screenshots - A ,   Mental Health among Women - screenshots - B ,   Environmental Health Training - screenshots - A ,   Environmental Health - Screenshots - B ,   Integrated Pest Management - screenshots - A ,   Integrated Pest Management - screenshots - B ,   Emergency Supplies - screenshots - A ,   Emergency Supplies - screenshots - B ,   Congenital Heart Defects - screenshots - A ,   Congenital Heart Defects - screenshots - B ,   Flu shots - screenshots - A ,   Flu shots - screenshots - B
Vital Signs Survey None, None Vital Signs Survey ,   Vital Signs Survey
Solve the Outbreak (14GM) none Questionnaire
Solve the Outbreak Mobile App Survey
Solve the Outbreak iPad Survey none Survey
CDC Homepage UX none Participant Scenario List
CDC Homepage Post-launch Survey none CDC Homepage Survey
CDC Spanish Homepage Survey none, none Spanish Homepage Survey ,   English Homepage Survey
CDC Social Media Satisfaction Survey
CDC Homepage Mobile & Desktop Survey None, None CDC Homepage Mobile and Desktop ,   CDC Homepage Mobile & Desktop Survey
Testing of Sample Materials Developed Using the CDC Clear Communications Index None, None, None, None, None, None, None, None, None Attachment 3: Flu Vaccine Information for Health Care Workers ,   Attachment 4: Autism and Developmental Disabilities Monitoring Network (ADDM) Tracking Autism in Wisconsin: What You Need to Know ,   Attachment 5: HAI Summary Data Reports: Questions and Answers ,   Attachment 6: Heart Disease Facts ,   Attachment 7: Use the Model Aquatic Health Code to Make Swimming Healthy and Safe ,   Attachment 8: The National Violent Death Reporting System (NVDRS): A Valuable Tool for Prevention ,   Attachment 9: CDC Priorities and FY 2014 Budget Request ,   Attachment 10: CDC Keeps America Healthy, Safe, and Secure. Case Study: Fort Leonard Wood, Missouri ,   Attachment 2: Click Testing Screen Shots
CDC Homepage UX -- After Release
  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 30,750 10,250 0 20,500 0 0
Annual Time Burden (Hours) 15,750 5,250 0 10,500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This change request is to add respondents and burden hours due to an error in the original clearance request.
$36,130
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [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.
02/25/2014