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Formative Evaluation for Shigellosis Sexual Health Materials for Men who have Sex with Men 17ABT
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener Attachment 2_Screener.docx Yes No Paper Only
Other-Moderator's Guide Attachment 4_FG Moderator Guide.pdf Yes No Paper Only

Health Illness Prevention

 

445 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 445 0 445 0 0 0
Annual IC Time Burden (Hours) 79 0 79 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement B MSM Shigellosis Formative Research_Part B.docx 05/03/2017
Supporting Statement A MSM Shigellosis Formative Research_Part A_050417.docx 05/08/2017
Request for Approval GenICRequestTemplate_050417.docx 05/08/2017
Recruitment Script Attachment 3_Recruitment Script.docx 05/08/2017
Consent Attachment 5_Informed Consent.docx 05/08/2017
Baltimore message 5.Baltimore City Health Department.pdf 05/08/2017
Seattle Message 4.Seattle King County Web-based and Facebook Ads.docx 05/08/2017
Minnesota message 3.MN DH.pdf 05/08/2017
San Francisco message 2.SFDPH READING THIS MAY SAVE YOUR ASS - FINAL 03 13 13 (1).docx 05/08/2017
CDC message 1.CDC 2016.pdf 05/08/2017
IRB determination Attachment 6_IRB.pdf 05/08/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.