OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Assessing the Impact of Targeted Training and Technical Assistance Efforts on the Implementation of Comprehensive Cancer Control

ICR 201703-0920-006 · OMB 0920-1193 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
In-depth Interview with Selected Respondents to the Web-based Survey Form and Instruction New Available
Web-based Survey of NCCCP and NSBT Staff and Partners Form New Repair queued
Case Study Interview of DP13-1315 Partner Form and Instruction New Available
Case Study Interview of DP13-1314 Partner Form and Instruction New Available
Case Study Interview of DP13-1315 Evaluator Form and Instruction New Repair queued
Case Study Interview of DP13-1314 Evaluator Form and Instruction New Available
Follow-up Case Study Interview of DP13-1315 Program Director or Manager Form and Instruction New Available
Initial Case Study Interview of DP13-1315 Program Director or Manager Form and Instruction New Available
Follow-up Case Study Interview of DP13-1314 Program Director or Manager Form and Instruction New Available
Initial Case Study Interview of DP13-1314 Program Director or Manager Form and Instruction New Available
Worksheet for Identifying Case Study Interviewees Form and Instruction New Repair queued
Att 14_IRB Approval Letter.pdf Supplementary Document Uploaded 2017-05-01 Available
Att 13b_In Depth Interview Informed Consent.docx Supplementary Document Uploaded 2017-05-01 Available
Att 13a_Case Study Interview Informed Consent.docx Supplementary Document Uploaded 2017-05-01 Available
Att 12_Data collector Non-Disclosure Agreement.docx Supplementary Document Uploaded 2017-05-01 Available
Att 4_Evaluation Matrix.docx Supplementary Document Uploaded 2017-05-01 Available
Att 3b_Evaluation Conceptual Framework.docx Supplementary Document Uploaded 2017-05-01 Available
Att 3a_List of Awardees for DP13-1314 and DP13-1315.docx Supplementary Document Uploaded 2017-05-01 Available
Att 2_Federal Register Notice.pdf Supplementary Document Uploaded 2017-05-01 Available
Att 1_Authorizing Legislation PHSA.pdf Supplementary Document Uploaded 2017-05-01 Available
Part B_17AW_rev 4 06 17.docx Supporting Statement B Uploaded 2017-05-01 Available
Part A_17AW_rev 4 10 17.docx Supporting Statement A Uploaded 2017-05-01 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
226627 In-depth Interview with Selected Respondents to the Web-based Survey Form and Instruction New
226625 Web-based Survey of NCCCP and NSBT Staff and Partners Form New
226624 Case Study Interview of DP13-1315 Partner Form and Instruction New
226623 Case Study Interview of DP13-1314 Partner Form and Instruction New
226622 Case Study Interview of DP13-1315 Evaluator Form and Instruction New
226620 Case Study Interview of DP13-1314 Evaluator Form and Instruction New
226619 Follow-up Case Study Interview of DP13-1315 Program Director or Manager Form and Instruction New
226618 Initial Case Study Interview of DP13-1315 Program Director or Manager Form and Instruction New
226617 Follow-up Case Study Interview of DP13-1314 Program Director or Manager Form and Instruction New
226616 Initial Case Study Interview of DP13-1314 Program Director or Manager Form and Instruction New
226615 Worksheet for Identifying Case Study Interviewees Form and Instruction New
ICR Details
0920-1193 201703-0920-006
Historical Active
HHS/CDC 0920-17AW
Assessing the Impact of Targeted Training and Technical Assistance Efforts on the Implementation of Comprehensive Cancer Control
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/14/2017
Retrieve Notice of Action (NOA) 05/02/2017
  Inventory as of this Action Requested Previously Approved
07/31/2019 24 Months From Approved
815 0 0
231 0 0
12,451 0 0
The goal of this information collection is to document the implementation of training and technical assistance (TTA) administered by 10 DP13-1314 and DP13-1315 awardees to National Comprehensive Cancer Control Program (NCCCP) and National State-based Tobacco Control (NSBT) grantees and to explore TTA implemented is associated with grant goals. CDC will use findings to monitor TTA and inform the development of future TTA models to effectively support NCCCP and NSBT grantees.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  81 FR 73110 10/24/2016
82 FR 20342 05/01/2017
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 815 0 0 815 0 0
Annual Time Burden (Hours) 231 0 0 231 0 0
Annual Cost Burden (Dollars) 12,451 0 0 12,451 0 0
Yes
Miscellaneous Actions
No
This is a new information collection.
$253,976
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Renita Macaluso 770 488-6458 [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.
05/02/2017