OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services

ICR 202003-0920-013 · OMB 0920-1284 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920- Guest HIV Test Result Survey Form and Instruction Unchanged Available
Form 0920- Guest Consent Form Form and Instruction Unchanged Repair queued
Form 0920- Product Ordering Form and Instruction Unchanged Repair queued
Form 0920- Final HIV Test Result Survey (completion) Form and Instruction Unchanged Repair queued
Form 0920- Follow-up Form and Instruction Unchanged Repair queued
Form 0920- Initial HIV Test Result Survey Form and Instruction Unchanged Available
Form 0920- Baseline Survey Form and Instruction Unchanged Available
Form 0920- Registration Contact Information Form and Instruction Unchanged Available
Form 0920- Study Consent Form and Instruction Unchanged Available
Form 0920- Eligibility Screener Form and Instruction Unchanged Available
Form 0920- Eligibility Consent Form and Instruction Unchanged Available
Summary of Proposed Changes in the ICR for Web.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-03-19 Available
SS A FINAL 03FEB2020.docx Supplementary Document Uploaded 2020-02-03 Repair queued
Att 6_Screenshots.docx Supplementary Document Uploaded 2019-07-25 Repair queued
Att 5c_Data Sharing Agreement.doc Supplementary Document Uploaded 2019-07-25 Repair queued
Att 3b_Registration contact info.docx Supplementary Document Uploaded 2019-07-25 Repair queued
Att 2a_Public Comment_Whitman_Walker Comments _ Docket No. CDC_2018_0102.pdf Supplementary Document Uploaded 2019-07-25 Available
Att 5b_PIA_Form_iSTAMP approved (03-04-2019).pdf Supplementary Document Uploaded 2019-07-18 Available
Att 5a_Emory IRB Approval.pdf Supplementary Document Uploaded 2019-07-18 Available
Att 2_60 Day FRN.pdf Supplementary Document Uploaded 2019-07-18 Available
Att 1_Authorizing Legislation.docx Supplementary Document Uploaded 2019-07-18 Available
SS B final.docx Supporting Statement B Uploaded 2020-03-19 Available
SS A final.docx Supporting Statement A Uploaded 2020-03-19 Available
IC Document Collections
IC IDCollectionTypeStatusForm
237106 Guest HIV Test Result Survey Form and Instruction Unchanged
237105 Guest Consent Form Form and Instruction Unchanged
237104 Product Ordering Form and Instruction Unchanged
237099 Final HIV Test Result Survey (completion) Form and Instruction Unchanged
237098 Follow-up Form and Instruction Unchanged
237096 Initial HIV Test Result Survey Form and Instruction Unchanged
237094 Baseline Survey Form and Instruction Unchanged
237093 Registration Contact Information Form and Instruction Unchanged
237091 Study Consent Form and Instruction Unchanged
237025 Eligibility Screener Form and Instruction Unchanged
237024 Eligibility Consent Form and Instruction Unchanged
ICR Details
0920-1284 202003-0920-013
Active 201907-0920-005
HHS/CDC 0920-1284
Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/02/2020
Retrieve Notice of Action (NOA) 03/19/2020
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. All publications will note the change in methodology and the reasons for implementing such a change.
  Inventory as of this Action Requested Previously Approved
02/28/2023 02/28/2023 02/28/2023
15,200 0 15,200
1,517 0 1,517
0 0 0
The goal of this study is to evaluate the effectiveness of mailing out rapid HIV home-testing kits and additional testing promotion components to increase HIV testing among black/African American and Hispanic/Latino MSM. The findings from this research will assist local and state health departments and community-based organizations in making decisions on how to improve HIV testing and linkage to HIV prevention services for black/African American and Hispanic/Latino MSM in the United States. We are requesting non-substantive modifications to this previously approved ICR. No changes are requested to survey/data collection instruments and there are no changes to the burden hours calculated for the study.
None
None
Not associated with rulemaking
  83 FR 62864 12/06/2018
84 FR 32918 07/19/2019
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 15,200 15,200 0 0 0 0
Annual Time Burden (Hours) 1,517 1,517 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a NEW information collection request.
$948,200
Yes Part B of Supporting Statement
    Yes
    Yes
Yes
No
No
No
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.
03/19/2020