OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Zika Emergency Package V: Assessment of Interventions Intended to Protect Pregnant Women in Puerto Rico from Zika virus Infections

ICR 201608-0920-008 · OMB 0920-1118 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Telephone Interview of Cases and Controls Form and Instruction Unchanged Available
Follow-Up Telephone Interview Form and Instruction Modified Available
Initial Telephone Interview Form and Instruction Modified Repair queued
0920-1118 Non-sub Change Request 8 15 16.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-08-15 Available
0920-1118 Non-sub Change Request.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-07-14 Available
Statement A 24 JUN2016.revised.docx Supporting Statement A Uploaded 2016-06-27 Repair queued
Attachment H.Logic Model of Puerto Rico Zika Response Activities.pptx Supplementary Document Uploaded 2016-06-17 Available
Attachment G.IRB determination letter for project 2.pdf Supplementary Document Uploaded 2016-06-17 Available
Attachment F.Projet 1.IRB letter of determination.pdf Supplementary Document Uploaded 2016-06-17 Available
Statement B 16JUN2016 FINAL.docx Supporting Statement B Uploaded 2016-06-17 Available
Emergency Review Request Memo - Zika 5 SIGNED.pdf Supplementary Document Uploaded 2016-06-10 Available
Att. B - Draft 60-Day FRN.docx Supplementary Document Uploaded 2016-06-10 Available
Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2016-06-10 Available
IC Document Collections
IC IDCollectionTypeStatusForm
222028 Telephone Interview of Cases and Controls Form and Instruction Unchanged
221889 Follow-Up Telephone Interview Form and Instruction Modified
221888 Initial Telephone Interview Form and Instruction Modified
ICR Details
0920-1118 201608-0920-008
Historical Active 201607-0920-003
HHS/CDC 16ATJ
Zika Emergency Package V: Assessment of Interventions Intended to Protect Pregnant Women in Puerto Rico from Zika virus Infections
No material or nonsubstantive change to a currently approved collection   No
Emergency 06/17/2016
Approved without change 08/16/2016
Retrieve Notice of Action (NOA) 08/16/2016
  Inventory as of this Action Requested Previously Approved
12/31/2016 12/31/2016 12/31/2016
2,900 0 2,900
892 0 892
0 0 0
CDC requests an Emergency Clearance to collect data for six months. The goal of this project is to find out if interventions are reaching pregnant women and having the intended effects along with getting feedback from pregnant women about the Zika prevention activities that have been implemented (e.g., Zika education sessions and prevention kits, vector control services, and communication activities). Findings will be used to improve the delivery of interventions and to inform decisions about future Zika prevention activities for pregnant women in Puerto Rico.
CDC needs this assessment to ensure that Zika prevention activities effectively educate, equip, and encourage women to participate in as many Zika prevention behaviors as possible. On-going evaluation is an important part of this program because it can reveal novel ways that women protect themselves from Zika, how effective the distribution of the Zika Prevention Kit has been in Puerto Rico, perceived severity and susceptibility to Zika, pregnant women’s self-efficacy in protecting themselves from Zika after the interventions have been implemented, as well as the extent to which target populations are using contents of the Zika Prevention Kit.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
No
  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 2,900 2,900 0 0 0 0
Annual Time Burden (Hours) 892 892 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$60,829
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [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.
08/16/2016