OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)

ICR 202204-0920-005 · OMB 0920-1254 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1254 COVID-19 Case Follow-Up Questionnaire Form and Instruction New Repair queued
Form 0920-1254 AIS Questionnaire Form and Instruction New Repair queued
Form 0920-1254 AIS Text Message Form and Instruction New Repair queued
Form 0920-1254 Mobility Questionnaire Form and Instruction New Repair queued
Form 0920-18ANU Specimen Collection Form and Instruction Modified Repair queued
Form 0920-18ANU Vector Control Intervention Questionnaire Form and Instruction Modified Missing upstream
Form 0920-18ANU Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction Modified Repair queued
Form 0920-18ANU Individual Questionnaire Form and Instruction Modified Repair queued
Form 0920-18ANU Household Representative Questionnaire Form and Instruction Modified Repair queued
Attachment 8_COPA questionnaires dropped questions.pdf Supplementary Document Uploaded 2022-04-07 Missing upstream
Attachment 6_Consent summary.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 2_Consent Forms - All Ages.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 7_IRB approval letter 171110-VR_IRB.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
COPA Signed PIA.pdf Supplementary Document Uploaded 2022-04-07 Missing upstream
Attachment 4_60 day FRN (2021-25449).pdf Supplementary Document Uploaded 2022-04-07 Repair queued
SSB COPA Revision 0920-1254.docx Supporting Statement B Uploaded 2022-04-07 Available
SSA COPA Revision 0920-1254.docx Supporting Statement A Uploaded 2022-04-07 Repair queued
10. COPA Flyer.pdf Supplementary Document Uploaded 2018-12-20 Repair queued
1. Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-12-20 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
252694 COVID-19 Case Follow-Up Questionnaire Form and Instruction New
252691 AIS Questionnaire Form and Instruction New
252686 AIS Text Message Form and Instruction New
252684 Mobility Questionnaire Form and Instruction New
234597 Specimen Collection Form and Instruction Modified
234596 Vector Control Intervention Questionnaire Form and Instruction Modified
234595 Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction Modified
234594 Individual Questionnaire Form and Instruction Modified
234590 Household Representative Questionnaire Form and Instruction Modified
ICR Details
0920-1254 202204-0920-005
Received in OIRA 201812-0920-004
HHS/CDC 0920-1254
Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)
Reinstatement with change of a previously approved collection   No
Regular 04/08/2022
  Requested Previously Approved
36 Months From Approved
72,145 0
4,349 0
36,970 0
The purpose of this project is to establish longitudinal follow-up of a community cohort and evaluate the impact of vector control interventions in 14 clusters in southern Puerto Rico. The investigators have prior experience working in these communities; however, there is minimal available information regarding the prevalence or incidence of infection with tropical arboviruses, density of Ae. aegypti mosquitoes, or cluster members’ knowledge, attitudes, and practices regarding behaviors intended to avoid mosquitoes. Such information will be needed to inform decision-making regarding the location, design, and content of interventions to be implemented and evaluated to reduce the burden of these pathogens. This Reinstatement includes updated estimates for the number of respondents based on participation rates in the most recent year. We also request OMB approval for changes to the content of all four questionnaires and for the addition of the AIS text messaging system, the AIS questionnaire, and the COVID-19 case follow up questionnaire. Burden to respondents will increase by 838 hours per year.
US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  86 FR 66311 11/22/2021
87 FR 20863 04/08/2022
No
9
IC Title Form No. Form Name
AIS Questionnaire 0920-1254 AIS Questionnaire - Data Collection Instruments (combined English/Spanish)
AIS Text Message 0920-1254 AIS Text Message - Data Collection Instruments (combined English/Spanish)
COVID-19 Case Follow-Up Questionnaire 0920-1254 COVID-19 Case Follow-Up Questionnaire
Household Representative Questionnaire 0920-18ANU, 0920-1254 Household Representative Questionnaire ,   Household Representative Questionnaire - Data Collection Instruments (combined English/Spanish)
Individual Questionnaire 0920-18ANU, 0920-18ANU, 0920-1254 Individual Questionnaire ,   Individual Questionnaire Spanish ,   Individual Questionnaire - Data Collection Instruments (combined English/Spanish)
Knowledge, Attitudes, and Practices Individual Questionnaire 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-1254 KAP Adult ,   KAP Older Child ,   KAP Younger Child ,   Spanish KAP Adult ,   Spanish KAP Older Child ,   Spanish KAP Younger Child ,   Year Two Combined Questionnaire ,   Knowledge, Attitudes and Practices (KAP) Questionnaire - Data Collection Instruments (combined English/Spanish)
Mobility Questionnaire 0920-1254 Mobility Questionnaire - Data Collection Instruments (combined English/Spanish)
Specimen Collection 0920-18ANU, 0920-1254 Specimen Lab Form ,   Specimen Collection - Data Collection Instruments (combined English/Spanish)
Vector Control Intervention Questionnaire 0920-18ANU, 0920-18ANU, 0920-1254 Vector Control Questionnaire ,   Spanish Vector Control Questionnaire ,   Vector Control Questionnaire - Data Collection Instruments (combined English/Spanish)
  Total Request 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 72,145 0 0 56,025 0 16,120
Annual Time Burden (Hours) 4,349 0 0 878 0 3,471
Annual Cost Burden (Dollars) 36,970 0 0 11,804 0 25,166
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Reinstatement with Change for 0920-1254 includes revisions to existing data collection instruments, and addition of new data collection instruments to the previously approved collection. Total burden increases by 838 burden hours.
$2,073,176
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
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.
04/08/2022