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

View Information Collection (IC)

[NCCDPHP] Focus Groups with Adults who Smoke Cigarettes (2023) 0920-0910-23DQ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Focus Group Recruitment Screener 0910 Attachment 2 - Focus Group Recruitment Screener_20221216_clean.docx Yes Yes Fillable Fileable
Form and Instruction None Pre-Focus Group Questionnaire (screenshots) 0910 Attachment 5 - Pre-Focus Group Questionnaire Screenshots_03232027.pdf Yes Yes Fillable Fileable
Form and Instruction None In-Person Focus Group Moderator's Guide 0910 Attachment 6 - In-Person Focus Group Moderator's Guide_20230327.docx No   Paper Only
Form and Instruction None Online Focus Group Moderator's Guide 0910 Attachment 7 - Online Focus Group Moderator's Guide_20230327.docx Yes Yes Fillable Fileable
Form and Instruction None Post-Focus Group Questionnaire (screenshots) 0910 Attachment 8 - Post-Focus Group Questionnaire Screenshots_03232027.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

5,108 0
   
Individuals or Households
 
   90 %

  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 5,108 0 5,108 0 0 0
Annual IC Time Burden (Hours) 1,361 0 1,361 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A 0910 SSA_Focus groups with adults who smoke cigarettes_20230327 revised.docx 03/31/2023
Supporting Statement Part B 0910 SSB_Focus groups with adults who smoke cigarettes_20230327.docx 03/31/2023
Privacy Policy of Data Collection Contractor Attachment 1 - Schlesinger Privacy Policy.docx 03/31/2023
Informed Consent for In-person Focus Groups 0910 Attachment 3 - Informed Consent for In-Person Focus Groups_20230327.docx 03/31/2023
Informed Consent for Online Focus Groups 0910 Attachment 4 - Informed Consent for Online Focus Groups Screenshots_20230327.pdf 03/31/2023
Determination: IRB approval is not required 0910 Attachment 9 - Battelle Institutional Review Board Exemption.pdf 03/31/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.