View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

CDC Latent Tuberculosis Infection Campaign: Message Testing with Consumers Born in The Philippines and Vietnam 0920-21DE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Recruitment Screener (English) ATTCH 1a_LTBI Screener_Consumer.docx Yes Yes Fillable Fileable
Form and Instruction n/a Recruitment Screener (Vietnamese) ATTCH 1b_LTBI Screener_Consumer_Vietnamese.pdf Yes Yes Fillable Fileable
Form and Instruction n/a Virtual Focus Group Guide for Consumers (English) ATTCH 3a_LTBI Moderator Guide-FG_Consumer.docx Yes Yes Fillable Fileable
Form and Instruction n/a Virtual Focus Group Guide for Consumers (Vietnamese) ATTCH 3b_LTBI Moderator Guide_Vietnamese.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

600 0
   
Individuals or Households
 
   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 600 0 600 0 0 0
Annual IC Time Burden (Hours) 143 0 143 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HMTS Template with Project Overview HMTSExpeditedReviewForm_LTBI_Consumers_02112021 (1).pdf 02/19/2021
Supporting Statement Part A SSA_LatentTB_Consumers_02112021.docx 02/19/2021
Supporting Statement Part B SSB_LatentTB_Consumers_02112021.docx 02/19/2021
Participant Information Sheet (English) ATTCH 2a_LTBI Consumer Information Sheet.docx 02/19/2021
Participant Information Sheet (Vietnamese) ATTCH 2b_LTBI Consumer Info Sheet_Vietnamese.docx 02/19/2021
Campaign Messages and Materials for Testing ATTCH 4a_LTBI Campaign Consumer Creative.pdf 02/19/2021
Non-research and PRA determinations ATTCH 5a_Non-research and OMB PRA Project Determinations.pdf 02/19/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.