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[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak
[OS] CDC/ATSDR Formative Research and Tool Development
OMB: 0920-1154
IC ID: 271822
OMB.report
HHS/CDC
OMB 0920-1154
ICR 202506-0920-010
IC 271822
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:
2025-07-03 - No material or nonsubstantive change to a currently approved collection
2025-07-01 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak
Form and Instruction
Personal Protective Equipment Key Informant Interviews
Att1-Key InformantInterview.docx
Form and Instruction
Online Survey Questionnaire (to be amended as appropriat
Att2- Draft Survey.docx
Form and Instruction
GenICRequestTemplate_PPE Distribution_H5N1 Outbreak-PRArev_final.docx
GenIC Request Template
IC Document
SSA-0920-1154-DSLR PPE_clean_final.docx
SSA
IC Document
SSB-0920-1154-DSLR PPE.docx
SSB
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
[CPR] Successes of and Barriers to Distribution of Personal Protective Equipment (PPE) During the 2024 Dairy Cattle H5N1 Outbreak
Agency IC Tracking Number:
0920-1154-25AP
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
n/a
Personal Protective Equipment Key Informant Interviews
Att1-Key InformantInterview.docx
Yes
No
Fillable Fileable
Form and Instruction
n/a
Online Survey Questionnaire (to be amended as appropriate following review of KII responses)
Att2- Draft Survey.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
65
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
75 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
65
0
0
0
0
65
Annual IC Time Burden (Hours)
111
0
0
0
0
111
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
GenIC Request Template
GenICRequestTemplate_PPE Distribution_H5N1 Outbreak-PRArev_final.docx
10/23/2024
SSA
SSA-0920-1154-DSLR PPE_clean_final.docx
10/23/2024
SSB
SSB-0920-1154-DSLR PPE.docx
10/23/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.