OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCCDPHP] Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

ICR 202308-0920-009 · OMB 0920-0612 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0612 WISEWOMAN Program Minimum Data Elements (MDE) Form and Instruction Modified Available
Annual Progress Report Form and Instruction Modified Repair queued
OMB Change Request_08182023.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-08-22 Repair queued
OMB Change Request_04182023.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-04-18 Available
Att 7 Consent Guidance.pdf Supplementary Document Uploaded 2022-08-11 Available
60-day FRN_06022022.pdf Supplementary Document Uploaded 2022-08-11 Available
Att 2b WISEWOMAN Prg Mgrs Dirs Data Mgrs.pdf Supplementary Document Uploaded 2022-08-11 Available
Att 2a WISEWOMAN Awardees Map.png Supplementary Document Uploaded 2022-08-11 Repair queued
Att 1b Sec 301 PHSA.pdf Supplementary Document Uploaded 2022-08-11 Available
Att 1a NBCCEDP Law Statute.pdf Supplementary Document Uploaded 2022-08-11 Available
0920-0612 SSB_08032022.docx Supporting Statement B Uploaded 2022-08-11 Available
0920-0612 SSA_08032022.docx Supporting Statement A Uploaded 2022-08-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
37802 WISEWOMAN Program Minimum Data Elements (MDE) Form and Instruction Modified
191867 Annual Progress Report Form and Instruction Modified
ICR Details
0920-0612 202308-0920-009
Active 202304-0920-005
HHS/CDC 0920-0612-23HT
[NCCDPHP] Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/23/2023
Retrieve Notice of Action (NOA) 08/23/2023
  Inventory as of this Action Requested Previously Approved
03/31/2025 03/31/2025 03/31/2025
120 0 105
2,640 0 2,310
0 0 0
CDC requests OMB approval for 11 additional data elements that align with the current purpose and scope of existing WISEWOMAN data elements. The additional MDE will strengthen: • Program fidelity: Proposed additional elements will involve ascertaining social needs and will help decipher ways to mitigate barriers that are preventing active participation in the WISEWOMAN program. These proposed changes will improve CDC’s ability to improve CVD risk analysis and program efficacy. • Data Quality: Proposed changes to MDEs provide companion data to existing data elements to provide a more complete picture for underserved women in the WISEWOMAN Program. This request is a refinement of our current data approach of continuously serving underserved populations and also in line with HHS’s current health equity goals.
US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 101 - 354 300 Name of Law: The Breast and Cervical Cancer Mortality Prevention Act of 1990
  
None
Not associated with rulemaking
  87 FR 33487 06/02/2022
87 FR 49848 08/12/2022
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 120 105 0 15 0 0
Annual Time Burden (Hours) 2,640 2,310 0 330 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This request is a refinement of our current data approach of continuously serving underserved populations and also in line with HHS’s current health equity goals. The additional data element and refinement of an existing data element emanate from the upcoming cooperative agreement (CDC-RFA-DP-23-0003) that was published in late March and application process is ongoing. This additional MDE and refinement of an existing MDE will help improve analytical utility, program fidelity, and data quality and will have negligible impact on burden hours. Overall, if approved the total number of MDEs will be 71. CDC is submitting this change request to OMB to provide Minimum Data Elements implementation guidance to programs for the new program year, which begins at the end of September 2023. The change in burden with the addition of one MDE and minor revision of an existing MDE question in non-substantive. Only the total estimated annualized burden hours are being updated to reflect 40 programs.
$384,750
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Thelma Sims 4046394771
  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.
08/23/2023