Information Collection Request

Traumatic Brain Injury Disparities in Rural Areas (TBIDRA)

ICR 201810-0920-010 · OMB 0920-1256 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-18AFX Focus Group Questionnaire Form and Instruction New Repair queued
Form 0920-18AFX Focus Group Discussion Guide Form and Instruction New Available
Form 0920-18AFX Focus Group Consent Form and Instruction New Available
Form 0920-18AFX Focus Group Screener Form and Instruction New Available
Attachment 04_Focus Group Invitation Email.docx Supplementary Document Uploaded 2019-04-01 Repair queued
Attachment 01_ PHSA Authorizing Legislation.doc Supplementary Document Uploaded 2019-04-01 Available
Attachment 10_IRB Exemption.docx.pdf Supplementary Document Uploaded 2019-04-01 Repair queued
Attachment 09_ PIA_ TBIDRA-PIA-08-14-2018-Signed.pdf Supplementary Document Uploaded 2019-04-01 Available
Attachment 13_Web Survey Question Categorization.docx Supplementary Document Uploaded 2018-11-05 Available
Attachment 11_Web survey reminder email.docx Supplementary Document Uploaded 2018-11-05 Repair queued
Attachment 10_Web Survey Invitation Email.docx Supplementary Document Uploaded 2018-11-05 Available
Attachment 9_Focus Group Question Categorization.docx Supplementary Document Uploaded 2018-11-05 Available
Attachment 06_Focus Group Consent Form.docx Supplementary Document Uploaded 2018-11-05 Available
Attachment 02_FRN_TBI Rural Areas.pdf Supplementary Document Uploaded 2019-04-01 Available
SSB_18AFX_TBIDRA_Passback - CLEAN.docx Supporting Statement B Uploaded 2019-04-01 Available
SSA_18AFX_TBIDRA_Passback - FINAL CLEAN.docx Supporting Statement A Uploaded 2019-04-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
235537 Focus Group Questionnaire Form and Instruction New
233901 Focus Group Discussion Guide Form and Instruction New
233899 Focus Group Consent Form and Instruction New
233898 Focus Group Screener Form and Instruction New
ICR Details
0920-1256 201810-0920-010
Active
HHS/CDC 0920-18AFX
Traumatic Brain Injury Disparities in Rural Areas (TBIDRA)
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 04/02/2019
Retrieve Notice of Action (NOA) 11/28/2018
Approval is granted to conduct focus groups. If CDC determines that the focus group results support additional data collection, CDC should engage OMB in a discussion early in the development process in order to determine whether additional public notice is needed.
  Inventory as of this Action Requested Previously Approved
04/30/2021 24 Months From Approved
124 0 0
48 0 0
0 0 0

The study, “Traumatic Brain Injury Disparities in Rural Areas (TBIDRA)” will help CDC to better understand the challenges that rural healthcare providers face in diagnosing, treating, and managing mild TBIs - the most common type of TBI - and identify areas for future research that will allow us to better understand these challenges and potential ways to address them.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  83 FR 26464 06/07/2018
83 FR 58571 11/20/2018
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 124 0 0 124 0 0
Annual Time Burden (Hours) 48 0 0 48 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a New ICR

$26,336
No
    Yes
    No
No
No
No
Uncollected
Kevin Joyce 404 639-1944 [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.
11/28/2018