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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Informing Development of CDC Content about Sexually Transmitted Diseases: Focus Groups with Men Who Have Sex With Men
Agency IC Tracking Number:
0920-21BS
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
n/a
Recruitment Guide for MSM
Attachment C1_ Recruitment Guide for MSM.docx
Yes
Yes
Fillable Fileable
Form and Instruction
n/a
Moderator Guides for Web/Telephone Focus Groups
Attachment D1_Moderator Guides D1-A and D1-B for Focus Groups.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:
95
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
95
0
95
0
0
0
Annual IC Time Burden (Hours)
106
0
106
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Authorizing Legislation: PHSA
Attachment A1_Authorizing Legislation.docx
01/05/2021
Consent Form
Attachment B1_Consent Forms for MSM.docx
01/05/2021
Messages to be Tested with MSM
Attachment E1_Messages for MSM .docx
01/05/2021
Determination: IRB Approval Is Not Required
Att F1_Project Determination Amendment 12 20.docx
01/05/2021
HMTS Submission Template
HMTSExpeditedReviewForm_1220.pdf
01/05/2021
Supporting Statement Part A
DSTDP MSM Message Testing Part 1 (MSM) SSA_01052021.docx
01/05/2021
Supporting Statement Part B
DSTDP MSM Message Testing Part 1 (MSM) SSB_01052021.docx
01/05/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.