OMB control number

[NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program

OMB 0920-1453 · HHS/CDC.

OMB 0920-1453

The purpose of the project is to conduct a comprehensive implementation and outcome evaluation to assess the unique contributions of The National Cardiovascular Health Program (The National CVH Program), The Innovative Cardiovascular Health Program (The Innovative CVH Program), and Well-Integrated Screening and Evaluation of Women Across the Nation (WISEWOMAN) cooperative agreements to identify promising cardiovascular disease (CVD) prevention and management practices that can be scaled and replicated, advance health equity, and the transformation of health systems for improved CVD prevention and management. The programs work together to create efficiencies and improve outcomes in jurisdictions that receive funding for two or more of the cooperative agreements. This Evaluation aims to assess implementation, assess the extent to which short-term, intermediate, and long-term outcomes have been met, and estimate the costs involved in program implementation. This Non-Substantive Change Request is submitted to revise questions to align with recent executive orders, EO 14168 and EO 14151. There is no change anticipated to the currently approved burden hours.

The latest form for [NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program expires 2027-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1453 Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a) Form and Instruction
Form 0920-1453 Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a) Form and Instruction
Form 0920-1453 Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c) Form and Instruction
Form 0920-1453 Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c) Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b) Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b) Form and Instruction
Form 0920-1453 Cost Study Interview Guide_Partner (Attachment 5d) Form and Instruction
Form 0920-1453 Cost Study Interview Guide_Partner (Attachment 5d) Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m) Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m) Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l) Form and Instruction
Form 0920-1453 Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l) Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i) Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i) Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h) Form and Instruction
Form 0920-1453 Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h) Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e) Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e) Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d) Form and Instruction
Form 0920-1453 Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d) Form and Instruction
Form 0920-1453 Eval Assessment CCL Partner Interview Guide WW (Attachment 3o) Form and Instruction
Form 0920-1453 Eval Assessment CCL Partner Interview Guide WW (Attachment 3o) Form and Instruction
Form 0920-1453 Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n) Form and Instruction
Form 0920-1453 Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n) Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide WW (Attachment 3k) Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide WW (Attachment 3k) Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j) Form and Instruction
Form 0920-1453 Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j) Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide WW (Attachment 3g) Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide WW (Attachment 3g) Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f) Form and Instruction
Form 0920-1453 Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f) Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a) Form and Instruction
Form 0920-24FI Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a) Form and Instruction
Form 0920-24FI Cost Study Interview Guide_Recipient (Attachment 5c) Form and Instruction
Form 0920-24FI Cost Study Interview Guide_Recipient (Attachment 5c) Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k) Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k) Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j) Form and Instruction
Form 0920-1453 Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j) Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g) Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g) Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f) Form and Instruction
Form 0920-1453 Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f) Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c) Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c) Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b) Form and Instruction
Form 0920-1453 Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b) Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m) Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m) Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l) Form and Instruction
Form 0920-1453 Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l) Form and Instruction
Form 0920-1453 Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i) Form and Instruction
Form 0920-1453 Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i) Form and Instruction
Form 0920-1453 Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h) Form and Instruction
Form 0920-1453 Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h) Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e) Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e) Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d) Form and Instruction
Form 0920-1453 Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d) Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_WW (Attachment 3b) Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_WW (Attachment 3b) Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a) Form and Instruction
Form 0920-1453 Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a) Form and Instruction
Change Request Memo - Template NCCDPHP EPET Comp Eval 4_18_25.docx Justification for No Material/Nonsubstantive Change
Change Request Memo - Template NCCDPHP EPET Comp Eval 4_18_25.docx Justification for No Material/Nonsubstantive Change
SSB_VF_2025.04.29.docx Supporting Statement B
SSB_VF_2025.04.29.docx Supporting Statement B
SSA_VF_2025.04.29.docx Supporting Statement A
SSA_VF_2025.04.29.docx Supporting Statement A
Att 2c. 42 USC Section 241a.docx Supplementary Document
Att 2c. 42 USC Section 241a.docx Supplementary Document
Att 2f. FY 2023 Consolidated Appropriations Act.pdf Supplementary Document
Att 2f. FY 2023 Consolidated Appropriations Act.pdf Supplementary Document
Att 2e. 42 USC 300I.docx Supplementary Document
Att 2e. 42 USC 300I.docx Supplementary Document
Att 2d. 42 USC 300n-4a.docx Supplementary Document
Att 2d. 42 USC 300n-4a.docx Supplementary Document
Att 2b. 42 USC 300u-11.pdf Supplementary Document
Att 2b. 42 USC 300u-11.pdf Supplementary Document
Att 2a. 42 USC 247b.pdf Supplementary Document
Att 2a. 42 USC 247b.pdf Supplementary Document
Att 1c. CDC-RFA-DP-23-0003_Revised_Wisewoman.pdf Supplementary Document
Att 1c. CDC-RFA-DP-23-0003_Revised_Wisewoman.pdf Supplementary Document
Att 1b. CDC-RFA-DP-23-0005_Innovative.pdf Supplementary Document
Att 1b. CDC-RFA-DP-23-0005_Innovative.pdf Supplementary Document
Att 1a. CDC-RFA-DP-23-0004_National.pdf Supplementary Document
Att 1a. CDC-RFA-DP-23-0004_National.pdf Supplementary Document
Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a) Form and Instruction
Ex Assessment LC Interview Guide NCHP_ICHP (Attachment 4a) Form and Instruction
Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c) Form and Instruction
Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c) Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b) Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner (Attachment 5b) Form and Instruction
Cost Study Interview Guide_Partner (Attachment 5d) Form and Instruction
Cost Study Interview Guide_Partner (Attachment 5d) Form and Instruction
Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m) Form and Instruction
Ex Assessment CCL Partner Interview Guide_WW (Attachment 4m) Form and Instruction
Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l) Form and Instruction
Ex Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 4l) Form and Instruction
Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i) Form and Instruction
Ex Assessment TBC Partner Interview Guide_WW (Attachment 4i) Form and Instruction
Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h) Form and Instruction
Ex Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 4h) Form and Instruction
Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e) Form and Instruction
Ex Assessment CQM Partner Interview Guide_WW (Attachment 4e) Form and Instruction
Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d) Form and Instruction
Ex Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 4d) Form and Instruction
Eval Assessment CCL Partner Interview Guide WW (Attachment 3o) Form and Instruction
Eval Assessment CCL Partner Interview Guide WW (Attachment 3o) Form and Instruction
Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n) Form and Instruction
Eval Assessment CCL Partner Interview Guide NCHP_ICHP (Attachment 3n) Form and Instruction
Eval Assessment TBC Partner Interview Guide WW (Attachment 3k) Form and Instruction
Eval Assessment TBC Partner Interview Guide WW (Attachment 3k) Form and Instruction
Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j) Form and Instruction
Eval Assessment TBC Partner Interview Guide NCHP_ICHP (Attachment 3j) Form and Instruction
Eval Assessment CQM Partner Interview Guide WW (Attachment 3g) Form and Instruction
Eval Assessment CQM Partner Interview Guide WW (Attachment 3g) Form and Instruction
Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f) Form and Instruction
Eval Assessment CQM Partner Interview Guide NCHP_ICHP (Attachment 3f) Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a) Form and Instruction
Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient (Attachment 5a) Form and Instruction
Cost Study Interview Guide_Recipient (Attachment 5c) Form and Instruction
Cost Study Interview Guide_Recipient (Attachment 5c) Form and Instruction
Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k) Form and Instruction
Ex Assessment CCL Recipient Interview Guide_WW (Attachment 4k) Form and Instruction
Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j) Form and Instruction
Ex Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 4j) Form and Instruction
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g) Form and Instruction
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g) Form and Instruction
Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f) Form and Instruction
Ex Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 4f) Form and Instruction
Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c) Form and Instruction
Ex Assessment CQM Recipient Interview Guide_WW (Attachment 4c) Form and Instruction
Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b) Form and Instruction
Ex Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 4b) Form and Instruction
Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m) Form and Instruction
Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m) Form and Instruction
Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l) Form and Instruction
Eval Assessment CCL Recipient Interview Guide NCHP_ICHP (Attachment 3l) Form and Instruction
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i) Form and Instruction
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i) Form and Instruction
Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h) Form and Instruction
Eval Assessment TBC Recipient Interview Guide NCHP_ICHP (Attachment 3h) Form and Instruction
Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e) Form and Instruction
Eval Assessment CQM Recipient Interview Guide WW (Attachment 3e) Form and Instruction
Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d) Form and Instruction
Eval Assessment CQM Recipient Interview Guide NCHP_ICHP (Attachment 3d) Form and Instruction
Evaluability Assessment Nomination Form_WW (Attachment 3b) Form and Instruction
Evaluability Assessment Nomination Form_WW (Attachment 3b) Form and Instruction
Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a) Form and Instruction
Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a) Form and Instruction

All Historical Document Collections

202504-0920-030	No material or nonsubstantive change to a currently approved collection	2025-05-01
202410-0920-005 Approved without change	New collection (Request for a new OMB Control Number)	2024-11-08

OMB Details

Evaluability Assessment Nomination Form_NCHP_ICHP (Attachment 3a)

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-1453

Att 3a. Evaluability Assessment Nomination Form_NCHP_ICHP_rev 2025

N/A

Form and instruction

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