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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Co-creation of Digital Tools to Enhance Young Adult Minority Participation in COVID-19 Trials
Agency IC Tracking Number:
OC
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
Other-Screener
1. Co-creation of Digital Tools Study Screener_Phase 1_v2.docx
Yes
Yes
Fillable Fileable
Other-Informed Consent
2. Co-creation of Digital Tools Informed Consent_Phase 1_v5.docx
Yes
Yes
Fillable Fileable Signable
Other-Focus Group Guide
3. Co-creation of Digital Tools Focus Group Guide_Phase 1_v4.docx
Yes
Yes
Fillable Fileable
Other-Focus Group Debrief
4. Co-creation of Digital Tools Focus Group Debrief_Phase 1_v2.docx
Yes
Yes
Printable Only
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:
352
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
352
0
352
0
0
0
Annual IC Time Burden (Hours)
352
0
352
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo - Co-creation of Digital Tools to Enhance Young Adult Minority Participation in COVID-19 Trials
0497 OMB memo Co-creation of Digital Tools.pdf
06/23/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.