Change Request Justification

June 17, 2015

Biomonitoring of the Great Lakes Populations Program II:

Circumstances of Change Request for OMB #0923-0052

This is a nonmaterial/non-substantive change request for OMB protocol #0923-0052 (expiration date: April 30, 2017). OMB approval was granted for data collection for a cooperative agreement program involving the New York State Department of Health.

We are requesting to make non-substantive changes to the information collection forms per suggestions by the program’s Advisory Committee following OMB approval. Changes to the forms are to make the skip patterns logical, remove unnecessary scripts, and update questions where possible to maintain consistency between the two sub-populations.

The consent forms have also been modified to document oral consent if a prospective participant cannot read any of the translated consent forms. As presented in Supporting Statement A, page 16 section Opportunities to Consent to Sharing and Submission of Information: Any respondent indicating difficulty with reading will have the consent document read to him or her by the interviewer or an interpreter trained in appropriate Burmese or Bhutan dialects or Spanish language.

Attached please find revised forms with both a clean version and tracked changes document for each form, and the change request cross-walk table. The overall number of respondents and requested burden hours remains the same.

As such, we would appreciate your expedited consideration of this request.

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