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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
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
Agency IC Tracking Number:
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
0920-0572
Planes, Trains and Autop Appendix B3 Response Form
Appendix B3 Response Form.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Planes, Trains and Auto Appendix B Instructions for Interview
Appendix B Instructions for Interviewers 1.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Plane, Trains and Auto Appendix B 1 Interview 1
Appendix B1 Interview 1.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Planes, Trains and Autop Appendix B2 Interview Cards 1
Appendix B2 Interview 1 Cards.pptx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Planes, Trains Auto Appendix B4 Participant Inform
Appendix B4 Participant Information Sheet.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Plane, Trains and Auto Appendix 5 Question 1 Rationale
Appendix B5 Question 1 Rationale_v2.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Plane, Train Auto Appendix C Handheld Screenshots
Appendix C Handheld Screenshots.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brand Appendix A1-Screener-Consumers 010
Appendix A1-Screener-Consumers 010713.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brand concepts Appendix A2-Screener-HCP
Appendix A2-Screener-HCP 010713.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brand concepts Appendix B1-Consent form
Appendix B1-Consent form-Consumer FGs 122812.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brand concepts Appendix B2-Consent form-
Appendix B2-Consent form-HCP Triads 122812.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of Brand Appendix C1-Moderators Guide- Consumers FG
Appendix C1-Moderators Guide- Consumers FG 020613.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brands Appendix C2-Moderators Guide- HCP triads
Appendix C2-Moderators Guide- HCP triads 020613.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0572
Testing of brand Appendix D2-NDPP Branding Message Testing Supplement
Appendix D2-NDPP Branding Message Testing Supplement 010713.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
344
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
344
0
0
0
0
344
Annual IC Time Burden (Hours)
261
0
0
0
0
261
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Planes, Trains, Auto HMTSExpeditedReviewForm Interview 1
HMTSExpeditedReviewForm Interview 1.pdf
02/19/2013
NPPP Brand and Message Testing Expedited Review Form
HMTSExpeditedReviewForm- NPPP branding and message testing 011113.pdf
02/21/2013
Testing of brands list of Appendices
List of Appendices.docx
02/21/2013
Planes, Trains and auto Appendix A
Appendix A.docx
02/21/2013
Planes, Trains Auto Appendix A1 IRB Approval
Appendix A1 IRB Approval.docx
02/21/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.