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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
NHANES Contact and Message Testing
Agency IC Tracking Number:
0920-0222 (18QO)
IC Status:
New
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
Other-ord
Attachment 1 - Focus Group Protocol rev 020218.docx
No
Paper Only
Other-SCREENER
Attachment 3 - Screener.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Health and Demographic Surveys Conducted in Probability Samples of the US Population
FR Citation:
49 FR 37693
Number of Respondents:
164
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
164
0
164
0
0
0
Annual IC Time Burden (Hours)
105
0
105
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 2_Advertisement/Flyer
Attachment 2 - Advertisement.docx
02/20/2018
Att 4_Adult Informed Consent
Attachment 4 - Consent.docx
02/20/2018
Att 5_Respondent Data CollectionSheet
Attachment 5 - Respondent Data Collection Sheet.docx
02/20/2018
Att 6_Focus Group Thank you Letter
Attachment 6 - Thank You Letter.docx
02/20/2018
Att 7_Current Contact Protocol
Attachment 7 - Current NHANES Contact Material.pdf
02/20/2018
Att 8_Proposed NHANES Contact and Materials
Attachment 8 - Proposed NHANES Contact Material 02 07 2018.pdf
02/20/2018
Focus Group 10-Day Letter (Request for Approval 0920-0222 18QO)
NHANES Focus Group 10 day letter 021618.docx
02/20/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.