Prevention Research Centers Program National Evaluation Reporting System

Forms and Documents

Document Name	Status
PRC Indicator Survey Form	Modified
Attachment_6_0920-0650_60-day FRN_081215.pdf Supplementary Document	2016-01-11
Attachment_3_PRC_Evaluation_Purposes_Questions_Indicators_121615.docx Supplementary Document	2016-01-11
Attachment_2_List_of_Awardees_121615.docx Supplementary Document	2016-01-11
Attachment_1_Authorizing_Legislation_121615.pdf Supplementary Document	2016-01-11
0920-0650_SS_B_121615.docx Supporting Statement B	2016-01-11
0920-0650_SS_A_121815.docx Supporting Statement A	2016-01-11

IC Document Collections

IC ID	Document Title	Status
37806	PRC Indicator Survey Form	Modified
192734	PRC Key Informant Interview Other-Interview Guide	Modified

ICR Details

OMB Control No: 0920-0650	ICR Reference No: 201601-0920-008
Status: Historical Active	Previous ICR Reference No: 201303-0920-013
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Prevention Research Centers Program National Evaluation Reporting System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/07/2016
	Date Received in OIRA: 01/14/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	06/30/2016
Responses	43	0	74
Time Burden (Hours)	1,299	0	204
Cost Burden (Dollars)	0	0	0

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Abstract: CDC collects information from Prevention Research Centers to monitor awardees' activities and assess their progress toward achieving goals and objectives. The instruments are being revised to reflect updated performance indicators, increased emphasis on partnerships, and other changes in the evaluation plan.

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Authorizing Statute(s): PL: Pub.L. 98 - 551 771 Name of Law: Health Promotion and Disease Prevention Amendments of 1984
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 48318	08/12/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 1953	01/14/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
PRC Key Informant Interview
PRC Indicator Survey	none	PRCP Data Collection System

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ICR Summary of Burden

	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	43	74	0	-31	0	0
Annual Time Burden (Hours)	1,299	204	0	1,095	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Burden increase is due to a more comprehensive assessment of the time required to complete the data collection and to participate in interviews. There are decreases in the number of awardees and interview frequency.

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Annual Cost to Federal Government: $228,796

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/14/2016

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