EVALUATION OF THE PRESIDENTIAL YOUTH FITNESS PROGRAM

OMB Control No: 0920-1167	ICR Reference No: 201611-0920-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-16AQM
Title: EVALUATION OF THE PRESIDENTIAL YOUTH FITNESS PROGRAM
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/28/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/22/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	24 Months From Approved
Responses	4,330	0	0
Time Burden (Hours)	1,275	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC seeks approval to conduct the Presidential Youth Fitness Program (PYFP), School Administrator survey. This study is administered in schools to evaluate the impact of the PYFP on PE teacher, student and school-level outcomes, as well as barriers and facilitators to program implementation. Results will be used to (1) inform stakeholders about whether PE teacher, student and school-level outcomes differ among schools implementing the PYFP versus those offering a traditional physical education course and (2) provide information that will be used for program improvement.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. Public Health Service Act

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 38705	06/14/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 86330	11/30/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 15

IC Title Form No. Form Name FitnessGram Data Collection Form - 6th Grade Students PYFP Schools NA Fitness Gram Data Collection Form - 6th Grade Students in PYFP Schools Student Focus Group Moderator Guide - 6th Grade Students PYFP Schools NA Student Focus Group Moderator Guide - 6th Grade Student in PYFP School PYFP Cost Worksheet NA Cost Questionnaire - School Administrators in PYFP School Accelerometry Log - 6th Grade Students in Non-PYFP School NA Accelerometry Log - 6th Grade Students in Non-PYFP Schools Student Survey - 6th Grade Students in Non-PYFP Schools NA Student Survey - 6th Grade Students in Non-PYFP Schools PE Teacher Survey - Non-PYFP Schools NA PE Teacher Survey - Non-PYFP School School Administrator Survey - Non-PYFP School NA School Administrator Survey - Non-PYFP School PE Teacher Survey - PYFP Schools NA PE Teacher Survey - PE Teacher in PYFP School PE Teacher Focus Group Moderator Guide - PYFP School NA PE Teacher Focus Group Moderator Guide - PE Teacher in PYFP School PFYP Time Use Worksheet NA PYFP Time Use Information Sheet - PE Teacher in PYFP School School Administrator Survey (PYFP School) NA School Administrator Survey - School Administrator in PYFP School Parent Focus Group Moderator NA Parent Focus Group Moderator Guide - Parent of 6th Grade Student at PYFP School FitnessGram Data Collection Form - 6th Grade Students in Non-PYFP School NA FitnessGram Data Collection Form - 6th Grade Students in Non-PYFP School Accelerometry Log - 6th Grade Students PYFP Schools NA Accelerometry Log - 6th Grade Students in PYFP Schools Student Survey - 6th Grade Students PYFP Schools NA Student Survey - 6th Grade Students in PYFP Schools

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ICR Summary of Burden

	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	4,330	0	0	4,330	0	0
Annual Time Burden (Hours)	1,275	0	0	1,275	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Submission of 0920-16AQM is a New ICR.

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Annual Cost to Federal Government: $540,560

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Jeffrey Zirger 404 639-7118 [email protected]

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Common Form ICR:  No

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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:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(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;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
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.
Certification Date: 12/22/2016

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