OMB control number

[NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program

OMB 0920-1425 · HHS/CDC.

OMB 0920-1425

The goal of this ICR is to collect data to monitor project performance from grantees funded under Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action. Information collected from recipients will be used to monitor and evaluate progress of program goals and objectives, identify technical assistance needs, and be accountable for the funding by responding to requests for information about the cooperative agreement. The population studied will include 100% of EfC-funded recipients. Therefore, a sampling method is not required. Recipients will report performance data to CDC annually using a web-based system (i.e., Partners’ Portal). No research design or human subjects involved. Information will be also collected via virtual interview sessions. Quantitative data will be analyzed using descriptive and summary statistics. Qualitative data will be analyzed through thematic analysis to define priority area topics and emerging themes. This Non-Substantive Change Request is submitted for compliance with recently issued EOs 14168 and 14151. There is no anticipated change to the approved burden.

The latest form for [NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program expires 2026-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920 Instrument and Protocol Implementation Capacity Assessment (ICA) Form and Instruction
Form 0920 Essentials Instrument and Protocol Evaluation and Surveillance Survey Form and Instruction
Form 0920 Instrument and Protocol Surveillance Capacity Assessment (SCA) Form and Instruction
Form 0920 Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer Form and Instruction
Form 0920 Instrument and Protocol Key Informant Interview - Principal Investigators Form and Instruction
Form 0920- Annual Performance Report (APR) Tool Form and Instruction
Change Request Memo - EO14168 Updates Essentials for Childhood.docx Justification for No Material/Nonsubstantive Change
SSB_EfC_Program_9_14_23.docx Supporting Statement B
SSA_EfC Program_050125 EO clean.docx Supporting Statement A
Att. 8 Research Determination.pdf Supplementary Document
Att. 7 EfC-ICR-PII-Privacy Act-Determination.pdf Supplementary Document
Att. 1_PHSA_301a_USC_241a and Section 393USC 280b-1a.pdf Supplementary Document
Instrument and Protocol Implementation Capacity Assessment (ICA) Form and Instruction
Essentials Instrument and Protocol Evaluation and Surveillance Survey Form and Instruction
Instrument and Protocol Surveillance Capacity Assessment (SCA) Form and Instruction
Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer Form and Instruction
Instrument and Protocol Key Informant Interview - Principal Investigators Form and Instruction
Annual Performance Report (APR) Tool Form and Instruction

All Historical Document Collections

202507-0920-007	No material or nonsubstantive change to a currently approved collection	2025-07-10
202310-0920-004 Approved without change	New collection (Request for a new OMB Control Number)	2023-11-03

OMB Details

Annual Performance Report (APR) Tool

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-1425	Annual Performance Report (APR) Tool - Revised 22JUL2025	N/A	Form and instruction
Form 0920-	Annual Performance Report (APR) Tool	Fillable Fileable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.