Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Act Against AIDS Campaign Unchanged 1420 385 0 Form and Instruction none Screener - MSM
Form and Instruction none Interview - MSM
Form and Instruction none Screener - HIV+
Form and Instruction none Interview - HIV+
Form and Instruction none Interview - General Population
Form and Instruction none Invitation - General Population
African American STD Disparities Health Communications Project and Community Health Media Center Educational Campaign Materials Testing Unchanged 5950 2406 0 Form none African American Screener
Form none African American Survey
Form none Community Health Wave 1 Screener
Form none Community Health Wave 2 Screener
Form none Community Health Wave 3 Screener
Form none Community Health Wave 4 Screener
Form none Community Health Wave 1 Survey Screenshots
Form none Community Health Wave 2 Survey Screenshots
Form none Community Health Wave 3 Survey Screenshots
Form none Community Health Wave 4 Survey Screenshots
Agency for Toxic Substances and Disease Registry Task Order 15: Message Testing Unchanged 28 20 0 Form and Instruction 0920-0572 ATSDR-Message-Testing_Attachment-2_Screener-Consumers_Clean
Form and Instruction 0920-0572 ATSDR-Message-Testing_Attachment-5_Consumers
Form and Instruction 0920-0572 ATSDR-Message-Testing_Attachment-6_PublicHealthProfessionals
Form and Instruction 0920-0572 ATSDR-Message-Testing_Attachment-7_Communitymembers
Form and Instruction 0920-0572 ATSDR-Message-Testing_Attachment-8_Consent-Form
Audience Research on Self-Management Education Unchanged 120 200 0 Form and Instruction none Moderator's Guide
Form and Instruction none Screener
Audience Research on Self-Management Education, Phase III Unchanged 160 134 0 Form and Instruction 0920-0572 Attachment 4 Screener_10282014
Form and Instruction 0920-0572 Attachment 3 Mod Guide_10282014
CHMC-Testing Educational Campaign Materials with African American and Hispanic Audiences New 3800 1584 0 Other-PDF
Other-PDF
Other-PDF
Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing Unchanged 300 60 0 Other-Word
Other-Word
Other-Word
Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers Unchanged 120 154 0 Other-WORD
Other-WORD
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO) Unchanged 450 351 0 Form none Screener in English and Spanish
Form none Dicussion Guide in English and Spanish
HMTS Radiation Focus Group and Emergencies Infographics Unchanged 2088 372 0 Other-Word
Other-Word
Other-Word
Other-Word
Other-WORD
Other-WORD
Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders Unchanged 336 492 0 Form and Instruction 0920-0572 Moderators Guide- Engaged Public Triad
Instruction
Form and Instruction 0920-0572 Moderators Guide- Community Leaders Triad
Form and Instruction 0920-0572 Moderators Guide- General Public FG
Instruction
Instruction
Instruction
Msg Testing for (3) Expedited Reviews--Detonation of an Improv Nuc Devise (Span), AND Impact of a Truck Driver Pub Hth Prac Proj, AND Dissemination of Occup Safety & Hlth Materials thru Mex Consul Unchanged 644 199 0 Instruction
Form none Screening Instrument
Instruction
Other-Screen shots
Other-video
Other-video
Other-video
Form none Truck Driver Opinion Survey
Other-Recruitment Script_Spanish
Other-Recruitment Script_English Translation
Form none Exit Survey_Spanish
Other-Test
Form none Exit Survey_English Translation
Other-Test
Other-Test document
Other-Testing document
Other-Testing document
Pandemic Influenza Nonpharmaceutical Intervention Message Testing Unchanged 90 180 0 Form and Instruction none Screener
Form and Instruction none Moderator's Guide
Parents are the Key Teen Driving Safety Initiative Unchanged 174 119 0 Form and Instruction none Pediatrician Screener
Form and Instruction none Parent Message Testing Moderator's Guide
Form and Instruction none Parent Message Testing Moderator's Guide - Spanish
Form and Instruction none Pediatrician Message Testing Moderator's Guide
Form and Instruction none Parent Screener
Form and Instruction none Parent Screener - Spanish
Planes,Trains and Auto-Mobility: Increase Walking in the Atl Hartsfield-Jackson Arprt And Testing of brand concepts, msgs and material CDC National Diabetes Prevntion Program Unchanged 344 261 0 Form and Instruction 0920-0572 Planes, Trains and Autop Appendix B3 Response Form
Form and Instruction 0920-0572 Planes, Trains and Auto Appendix B Instructions for Interview
Form and Instruction 0920-0572 Plane, Trains and Auto Appendix B 1 Interview 1
Form and Instruction 0920-0572 Planes, Trains and Autop Appendix B2 Interview Cards 1
Form and Instruction 0920-0572 Planes, Trains Auto Appendix B4 Participant Inform
Form and Instruction 0920-0572 Plane, Trains and Auto Appendix 5 Question 1 Rationale
Form and Instruction 0920-0572 Plane, Train Auto Appendix C Handheld Screenshots
Form and Instruction 0920-0572 Testing of brand Appendix A1-Screener-Consumers 010
Form and Instruction 0920-0572 Testing of brand concepts Appendix A2-Screener-HCP
Form and Instruction 0920-0572 Testing of brand concepts Appendix B1-Consent form
Form and Instruction 0920-0572 Testing of brand concepts Appendix B2-Consent form-
Form and Instruction 0920-0572 Testing of Brand Appendix C1-Moderators Guide- Consumers FG
Form and Instruction 0920-0572 Testing of brands Appendix C2-Moderators Guide- HCP triads
Form and Instruction 0920-0572 Testing of brand Appendix D2-NDPP Branding Message Testing Supplement
Radiation Emergencies Infographics Focus Groups Unchanged 288 192 0 Form None Screening Instrument-Radiation Emergencies Infographics
Other-Moderator's Guide-Radiation Emergencies Infographics Focus Groups
Spanish Trench Safety CD-ROM Unchanged 100 100 0 Form none Survey - Spanish
Form none Recruitment Script
Storyboard Testing Focus Groups for "No Trespassing Means No Trespassing" Campaign Unchanged 96 48 0 Other-WORD
Other-WORD
Other-WORD
Other-WORD
Testing Business-Case Videos for CDC's Division of Community Health Unchanged 300 125 0 Form none Interview Guide for Videos
Form none Eligibility Screener for Business people
Form none Survey for Video Testing
Testing Health Messages in STEADI Oder Adult Fall Pevention Materials Among Caregivers Unchanged 244 128 0 Instruction
Other-Informal Caregiver Discussion Guide
Instruction
Other-Formal Caregiver Discussion Guide
Form None Informed Consent
Other-Review materials
Other-Review materials
Other-Review materials
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 17052 7510 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title