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

View Information Collection (IC)

HHS COVID-19 Public Education Campaign Parent & Teen Interview Dyads
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment A Guide Attachment A_BRANY Approved- HHS COVID-19 Public Education Campaign_Parent Teen Dyads_Discussion Guide - Both Vaccinated_07-26-2021_FINAL.pdf Yes Yes Fillable Fileable
Other-Attachment B Guide Attachment B_BRANY Approved- HHS COVID-19 Public Education Campaign_Parent Teen Dyads_Discussion Guide - Parent Hesitant on Teen Vaxx_07-26-2021_FINAL.pdf Yes Yes Fillable Fileable

Health Illness Prevention

 

1,200 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 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 160 0 160 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment C BRANY Screener Attachment C_BRANY Approved- HHS COVID-19 Public Education Campaign_Parent Teen Dyads_Screener - Both Vaccinated_7-26-21_FINAL.pdf 08/12/2021
Attachment D BRANY Screener Attachment D_BRANY Approved- HHS COVID-19 Public Education Campaign_Parent Teen Dyads_Screener - Parent Hesitant on Teen Vaxx_7-26-21_FINAL.pdf 08/12/2021
Attachment E BRANY Consent Form Attachment E_BRANY Approved- Parent Teen Dyads_Parent Consent Form (English)_08-04-21_clean.pdf 08/12/2021
Attachment F BRANY Permission Form Attachment F_BRANY Approved- Parent Teen Dyads_Parent Permission Form for Minor (English)_08-04-21_clean.pdf 08/12/2021
Attachment G BRANY Minor Form Attachment G_BRANY Approved- Parent Teen Dyad_Minor Assent Form (English)_V2_08-04-21_clean.pdf 08/12/2021
Attachment H BRANY Testing Ads Attachment H_BRANY Approved- HHS COVID-19 Public Education Campaign_Parent Teen Dyads_How to Access Creative Testing Ads.pdf 08/12/2021
Attachment I BRANY IRB approval Attachment I_IRB Approval PDF 21-074-821_SBER-Initial Review (Event ID# 185634)_20210810.pdf 08/12/2021
Supporting Statement B HHS COVID-19 Public Education Campaign_Parent Teen Dyads - Supporting Statement B.docx 08/12/2021
Supporting Statement A 0990-0281 Generic HHS COVID-19 Public Education Campaign_Parent Teen Dyads - Supporting Statement A.docx 08/12/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.