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Skin Cancer Messages among Racial Ethnic Groups at Risk for Delayed Diagnosis, Advanced Disease and Lower Survival 0920-17YM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction N/A Screener ATTACHMENT A1 Screener_04 24 17.docx No   Paper Only
Form and Instruction N/A Informed Consent and Rescreening Form ATTACHMENT A2 Rescreener and Consent form_04 24 17_0248pm.docx No   Paper Only
Form and Instruction N/A Focus Group Discussion Guide for African American Women ATTACHMENT B1 FG Guide African American Women 04 24 17.docx No   Paper Only
Form and Instruction N/A Focus Group Discussion Guide for Hispanic Women ATTACHMENT B2 FG Guide Hispanic Women 04 24 17.docx No   Paper Only
Form and Instruction N/A Focus Group Discussion Guide for African American Men ATTACHMENT B3 FG Guide African American Male 04 24 17.docx No   Paper Only
Form and Instruction N/A Focus Group Discussion Guide for Hispanic Men ATTACHMENT B4 FG Guide Hispanic Men 04 24 17.docx No   Paper Only
Form and Instruction N/A Digital Ad Response Sheet (completed during focus groups with men) ATTACHMENT B5 Digital Ad Response Sheet _ 04 25_17.docx No   Paper Only

Health Illness Prevention

 

756 0
   
Individuals or Households
 
   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 756 0 756 0 0 0
Annual IC Time Burden (Hours) 398 0 398 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Materials for Testing ATTACHMENT C Materials for testing_04 24 17.docx 04/24/2017
HMTS Review Form for Focus Group Testing of Skin Cancer Messages HMTS_Expedited_Review_Form_nbl_Revised_4_26_17_5pm.docx 04/25/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.