Pta

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Privacy Impact Assessment Form
v 1.21
Status

Form Number

Form Date

Question

Answer

1

OPDIV:

CDC

2

PIA Unique Identifier:

PIA-202404-2113

2a Name:

Formative Evaluation Youth Message Testing
General Support System (GSS)
Major Application

3

The subject of this PIA is which of the following?

Minor Application (stand-alone)
Minor Application (child)
Electronic Information Collection
Unknown

3a

Identify the Enterprise Performance Lifecycle Phase
of the system.

Implementation
Yes

3b Is this a FISMA-Reportable system?

4

Does the system include a Website or online
application available to and for the use of the general
public?

5

Identify the operator.

6

Point of Contact (POC):

7

Is this a new or existing system?

8

Does the system have Security Authorization (SA)?

No
Yes
No
Agency
Contractor
POC Title

Campaign Lead

POC Name

Jasmine Kenney

POC Organization NCIPC/DOP
POC Email

hbu2@cdc.gov

POC Phone

404-639-0826
New
Existing
Yes
No

8b Planned Date of Security Authorization
Not Applicable

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8c

Briefly explain why security authorization is not
required

N/A

10

Describe in further detail any changes to the system
that have occurred since the last PIA.

N/A
The Centers for Disease Control and Prevention’s (CDC)
National Center for Injury Prevention and Control (NCIPC),
Division of Overdose Prevention (DOP) is seeking to develop a
youth-focused campaign to communicate the mental/
behavioral health impacts and risk awareness and outcomes
related to substance use, drug overdose, and addiction.
The information collected will be used to:
1. Inform the development of a youth-focused campaign
centered on increasing awareness of risks and outcomes
related to drug use, drug overdose, and mental health.

11 Describe the purpose of the system.

For each activity, respondents will be given a series of items
(i.e., tasks) to read and respond to. Each activity will be made
up of approximately 20 to 23 tasks. Tasks will collect
information related to knowledge, attitudes, behaviors about
substance use and mental health, and perceptions of
Describe the type of information the system will
campaign concepts and messages related to substance use
collect, maintain (store), or share. (Subsequent
and mental health. Responses will consist of typed responses
12
questions will identify if this information is PII and ask from each participants including short answer responses,
about the specific data elements.)
results from selecting between two or more stimuli, a numeral
ranking or Likert-response to stimuli, and other similar
prompts. Example activities might include open-response
questions, rating prompts, and ranking activities for the stimuli.
Example stimuli include campaign posters, taglines, messages,
and social media posts.

Provide an overview of the system and describe the
13 information it will collect, maintain (store), or share,
either permanently or temporarily.

No PII will be collected during this data collection effort. During
data collection activities, participants will only be identified by
their first name and last initial, with no accompanying profile
picture, to protect their privacy and to increase their comfort
level with the discussion. None of the questions, prompts, or
data elements in the activities will require participants to share
information about themselves that is private or sensitive,
although participants may share whatever they choose. All
participants will be informed that all responses are voluntary,
and they do not have to respond to any questions that they do
not wish to answer.

14 Does the system collect, maintain, use or share PII?

Yes
No

REVIEWER QUESTIONS: The following section contains Reviewer Questions which are not to be filled out unless the user is an OPDIV
Senior Officer for Privacy.

Reviewer Questions
1

Are the questions on the PIA answered correctly, accurately, and completely?

Answer
Yes
No

Reviewer
Notes

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Reviewer Questions
2

Answer

Does the PIA appropriately communicate the purpose of PII in the system and is the purpose
justified by appropriate legal authorities?

Yes

Do system owners demonstrate appropriate understanding of the impact of the PII in the
system and provide sufficient oversight to employees and contractors?

Yes

No

Reviewer
Notes
3

No

Reviewer
Notes
4

Does the PIA appropriately describe the PII quality and integrity of the data?

Yes
No

Reviewer
Notes
5

Is this a candidate for PII minimization?

Yes
No

Reviewer
Notes
6

Does the PIA accurately identify data retention procedures and records retention schedules?

Yes
No

Reviewer
Notes
7

Are the individuals whose PII is in the system provided appropriate participation?

Yes
No

Reviewer
Notes
8

Does the PIA raise any concerns about the security of the PII?

Yes
No

Reviewer Program confirmed that the initial data collector, which is external to CDC, will manually
Notes clean all data prior to transfer to CDC.
9

Is applicability of the Privacy Act captured correctly and is a SORN published or does it need
to be?

Yes
No

Reviewer
Notes
10

Is the PII appropriately limited for use internally and with third parties?

Yes
No

Reviewer
Notes
11

Does the PIA demonstrate compliance with all Web privacy requirements?

Yes
No

Reviewer
Notes
12

Were any changes made to the system because of the completion of this PIA?

Yes
No

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Reviewer Questions

Answer

Reviewer
Notes

General Comments

OPDIV Senior Official
for Privacy Signature

It was determined that since this activity will involve the use of national survey panels from various
markets, the collection of first name and first initial of last name does not have probability of identifiability
of a specific individual.

Beverly E.
Walker -S

Digitally signed by
Beverly E. Walker -S
Date: 2024.05.31
09:29:45 -04'00'

HHS Senior
Agency Official
for Privacy

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