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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Leveraging Community Engagement and Electronic Health Record Strategies to Promote Diverse Participation in COVID-19 Clinical 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-Recruitment email
1. 0497 Recruitment Email Leveraging Community Engagement.docx
Yes
No
Printable Only
Other-Demographic screener
2. 0497 Leveraging Community Demographic Screener.docx
Yes
Yes
Fillable Fileable
Other-Focus group guide
3. 0497 Leveraging Community Focus Group Guide.docx
Yes
Yes
Fillable Fileable
Other-IRB information sheet
4. 0497 Leveraging Community IRB Information Sheet.docx
Yes
No
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:
60
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
60
0
60
0
0
0
Annual IC Time Burden (Hours)
120
0
120
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo - Leveraging Community Engagement and Electronic Health Record Strategies to Promote Diverse Participation in COVID-19 Clinical Trials
0497 OMB memo Leveraging Community Engagement and Health Record Strategies.docx
06/27/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.