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

View Information Collection (IC)

Youth and Young Adult Formative In-Depth Interviews on Health Equity and Tobacco Use 0920-1154-22GV
 
New
 
Voluntary
 
42 CFR 301

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1154 Parent/Guardian Email and Informed Consent 1154 OSH Qual Att 6_Parent Guardian Email Informed Consent 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Parent/Guardian Email and Informed Consent 1154 OSH Qual Att 3_Parent_Guardian_Recruitment_Screener_Questionnaire 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Young Adult Informed Consent 1154 OSH Qual Att 8_Young Adult_Informed_Consent 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Parent/Guardian Email and Youth Informed Assent 1154 OSH Qual Att 7_Parent_Email_Youth12-17_Informed_Assent 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Young Adult Recruitment Screener Questionnaire 1154 OSH Qual Att 5_Young Adult_Recruitment_Screener 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Youth Recruitment Screener Questionnaire 1154 OSH Qual Att 4_Youth 12-17_Recruitment_Screener_Questionnaire 7.12.22.docx No   Fillable Fileable Signable
Form and Instruction 0920-1154 Interview Guide 1154 OSH Qual Att 9_ Interview_Moderator_Guide 7.12.22.docx No   Fillable Fileable Signable

Health Illness Prevention

 

450 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 450 0 450 0 0 0
Annual IC Time Burden (Hours) 144 0 144 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA 1154 OSH Qual_SSA V2 7.12.22.docx 07/25/2022
SSB 1154 OSH Qual_SSB (002).docx 07/25/2022
Authorizing Legislation 1154 OSH Qual Att 1_Public Health Service Act_42 USC 241.pdf 07/25/2022
Formative Interview Protocol OSH Qualitative Inquiry_Deliverable 3.1_Protocol_05022022.docx 07/25/2022
STARS Determination STARS project summary_youth formative interviews.pdf 07/25/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.