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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Testing Health Communication Messages to Promote Hand Hygiene Behavior Among U.S. Adults
Agency IC Tracking Number:
0920-0572-19NL
IC Status:
New
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
Interview Guide
5. Interview Guide.docx
NA
No
Fillable Fileable
Form and Instruction
0920-0572
Screening Form
2. Screening Form final.docx
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
520
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
520
0
520
0
0
0
Annual IC Time Burden (Hours)
104
0
104
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recruitment Flyer
1. Recruitment Flyer.docx
01/24/2019
Notification Scripts
3. Notification Scripts.docx
01/24/2019
Consent Form
4. Consent Form.docx
01/24/2019
Non-Research Determination
6. Non-research determination.pdf
01/24/2019
Handwashing Poster
18_299080-A_Frankson_Handwashing Poster_no logo.pdf
01/24/2019
Man-in-Mirror Poster
HH-posters-v4-Man in MIrror-1_ Option 1_010318.jpg
01/24/2019
Mom and Child Poster
HH-posters-v4-Mom and Child-2_Option 2.jpg
01/24/2019
Review Form Template
HMTS Expedited Review Form HH Message Testing.20190103.pdf
01/24/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.