OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

HIV prevention among Latina transgender women who have sex with men: Evaluation of a locally developed intervention

ICR 201902-0920-019 · OMB 0920-1266 · Active

Forms and Documents
DocumentTypeStatusAvailability
Interview Form and Instruction New Available
Questionnaire Form and Instruction New Available
Contact Information Form and Instruction New Available
Eligibility Screener Form and Instruction New Repair queued
Chicas Supporting Statement B with comments CDC changes clean (05 June 2019)v2.docx Supporting Statement B Uploaded 2019-06-06 Available
Chicas Supporting Statement A with comments CDC changes clean (05 June 2019)v2.docx Supporting Statement A Uploaded 2019-06-06 Available
Att 7_ChiCAS Data Use Plan.docx Supplementary Document Uploaded 2019-02-25 Available
Att 8_PIA 0920-18AQQ FEB2018.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 10b_ChiCAS Appointment Card Spanish.docx Supplementary Document Uploaded 2019-02-25 Available
Att 10a_ChiCAS Appointment Card English.docx Supplementary Document Uploaded 2019-02-25 Available
Att 9b_ChiCAS Stay in Touch Spanish.docx Supplementary Document Uploaded 2019-02-25 Repair queued
Att 9a_ChiCAS Stay in Touch English.docx Supplementary Document Uploaded 2019-02-25 Available
Att 6c_ChiCAS IRB UNC Agreement.pdf Supplementary Document Uploaded 2019-02-25 Repair queued
Att 6b_ChiCAS IRB Triad Agreement.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 6a_ChiCAS IRB Approval.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 5b_ChiCAS Consent Spanish.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 5a_ChiCAS Consent English.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 3b_ChiCAS Recruitment Materials Spanish.pdf Supplementary Document Uploaded 2019-02-25 Repair queued
Att 3a_ChiCAS Recruitment Materials English.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 2_60-Day FRN.pdf Supplementary Document Uploaded 2019-02-25 Available
Att 1_Authorizing Legislation.docx Supplementary Document Uploaded 2019-02-25 Available
IC Document Collections
IC IDCollectionTypeStatusForm
235196 Interview Form and Instruction New
235195 Questionnaire Form and Instruction New
235194 Contact Information Form and Instruction New
235193 Eligibility Screener Form and Instruction New
ICR Details
0920-1266 201902-0920-019
Active
HHS/CDC 0920-18AQQ
HIV prevention among Latina transgender women who have sex with men: Evaluation of a locally developed intervention
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/10/2019
Retrieve Notice of Action (NOA) 03/11/2019
Approved consistent with the understanding that CDC will not be conducting any general research on the information collected. When communicating findings from this collection, all publications will clearly describe the scope and limitations of the study findings.
  Inventory as of this Action Requested Previously Approved
06/30/2021 36 Months From Approved
365 0 0
171 0 0
0 0 0
The purpose of this study is to evaluate the efficacy of ChiCAS (Chicas Creando Acceso a la Salud [Chicas: Girls Creating Access to Health]), a Spanish language intervention that provides HIV prevention services to Hispanic/Latina adult transgender women. The information collected through this study will be used to evaluate whether exposure to the ChiCAS intervention results in improvements in participants' self-reported HIV prevention behaviors, beliefs and attitudes. This study will use a randomized delayed-intervention comparison group design to compare pre- (baseline) and post-intervention (6-month) levels of HIV risk among participants who have received the intervention and participants who have not yet received the intervention (delayed intervention group).
US Code: 42 USC 241 Name of Law: U.S. PHSA
  
None
Not associated with rulemaking
  83 FR 45624 08/23/2018
84 FR 5682 02/22/2019
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 365 0 0 365 0 0
Annual Time Burden (Hours) 171 0 0 171 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Submission of 0920-18AQQ - HIV prevention among Latina transgender women who have sex with men: Evaluation of a locally developed intervention is a New ICR
$695,535
Yes Part B of Supporting Statement
    Yes
    Yes
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.
03/11/2019