View Information Collection (IC)

View Information Collection (IC)

Cognitive Testing of Occupational Safety and Health Questions for the Youth Risk Behavior Surveillance System (YRBSS) [with incentive level test] 0920-21FZ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Telephone Screening Script (for Target Respondents) Attachment 4 Telephone Screening Script CLEAN - Revised.docx Yes Yes Fillable Fileable
Form and Instruction n/a Telephone Screening Script (for Parent / Guardian) Attachment 4 Telephone Screening Script CLEAN - Revised.docx Yes Yes Fillable Fileable
Other-Virtual Interview Setup Support [see Sections III and IV] Attachment 1 - Procedures for Cognitive Testing of Occupational Safety and Health Questions for the YRBSS CLEAN Revised.docx Yes Yes Fillable Fileable
Form and Instruction n/a Questions to be Cognitively Tested Attachment 2- Questions to be Cognitively Tested CLEAN Revised.docx Yes Yes Fillable Fileable
Form and Instruction n/a Respondent Data Collection Sheet Attachment 6 -Adult Data Collection Sheet .docx Yes Yes Fillable Fileable
Form and Instruction n/a Follow-up Debriefing Discussion Attachment 8 Follow-up Discussion_.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0164, Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

150 0
   
Individuals or Households
 
   100 %

  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 150 0 150 0 0 0
Annual IC Time Burden (Hours) 71 0 71 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Procedures for Cognitive Testing of Occupational Health and Safety Questions for YRBSS Attachment 1 - Procedures for Cognitive Testing of Occupational Safety and Health Questions for the YRBSS CLEAN Revised.docx 06/23/2021
Recruitment Materials Attachment 3a-3d LettersAdFlyer_vcb042021 .docx 06/23/2021
Informed Consent Materials - Youth Assent and Parent/Guardian Permission Attachment 5a-5f Informed Consent CLEAN.docx 06/23/2021
Thank You Letter Attachment 7 – Thank You Letter.docx 06/23/2021
Guidance to Interviewers: Identifying, Managing, and Reporting Respondent Distress Attachment 9 - Distress guidance.docx 06/23/2021
10 day letter 10-day letter-virtual Occupational Safety and Health Questions for the YRBSS Revised CLEAN July 29 2021.docx 07/31/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.