Change Request Justification

Change Request Memo - EO14168 Template- GenIC-0920-1154 - ORR .docx

[OS] CDC/ATSDR Formative Research and Tool Development

Change Request Justification

OMB: 0920-1154

Document [docx]
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Non-substantive Change Request

OMB Control Number 0920-1154

Building resilience for State and Local Health Department Staff responding to public health emergencies

Date Submitted: 02/24/2025


Summary of request: CDC/ORR is requesting a change request to revise questions to align with EO 14168 Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.

Description of Changes Requested: This request updates sex questions used in Building resilience for State and Local Health Department Staff responding to public health emergencies to be in accordance with EO 14168. Please check the boxes below if your request includes:


x Revision of an existing question(s)

x Deletion of an existing question(s)


If revising an existing question, CDC is advised to use one of the two versions below and can state that CDC will be changing the current Gender/Sex question to:


What is your Sex?

- Male

- Female


OR


What is your Sex?

- Male

- Female

- Undetermined

- Missing Value [Null]


If removing an existing question, the question to be removed can be included here.


Description of these actions could also be included in the Table at the bottom of this document.


Description of Changes to Burden (if applicable):


Description of Changes to Burden (if applicable): Form

Approved Burden

Requested Burden

Form 1

(Att A)

TOTAL TIME: 200

Time per response: 10 minutes pre-intervention + 20 minutes post-intervention

# respondents: 400

TOTAL TIME: 250

Time per response: 10 minutes pre-intervention + 20 minutes post-intervention

# respondents: 500

Form 2

(Att B)

TOTAL TIME: 24

Time per response: 60

# respondents: 24

TOTAL TIME: 24

Time per response: 60

# respondents: 24

Form 3

(Att C)

TOTAL TIME: 60

Time per response: 60

# respondents: 60

TOTAL TIME: 60

Time per response: 60

# respondents:

Total

TOTAL TIME - 284

TOTAL TIME - 334

** If changes are only made to Gender/Sex question these are expected to result in no change in Burden Hours. Program can state: “There is no change in Burden Hours associated with the modifications made to comply with EO 14168” **

Other Considerations (optional): CDC can include other aspects associated with the submission of this Non-Substantive Change Request here (e.g., timing sensitivities, implementation requirements, etc.,).


Table A: Description of Changes (optional, helpful if multiple changes to multiple forms):

Type of Change

Question/Item

Requested Change

Form 1

Question Revision



Form 2

Question Deletion















File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorZirger, Jeffrey (CDC/OD/OS)
File Modified0000-00-00
File Created2025-07-02

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