View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Consumer Perceptions of Cessation and Harm Messaging (CHarM) Study 1	Agency IC Tracking Number:	CTP

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 Scripts			Attachment A- Recruitment Scripts_5.11.23.docx		Yes	Yes	Printable Only
Other-Online Pre-Screener			Attachment B- Online Pre-Screener_5.11.23.docx		Yes	Yes	Printable Only
Other-Telephone Screener			Attachment C- Telephone Screener_5.11.23.docx		No		Paper Only
Other- Social Media Ads			Attachment D- Social Media Ads_5.11.23.docx		Yes	No	Printable Only
Other-Confirmation Email and Reminder Scripts			Attachment E- Confirmation Email and Reminder Scripts_5.11.23.docx		Yes	No	Printable Only
Other-Informed Consent			Attachment F- Informed Consent_5.11.23.docx		Yes	Yes	Fillable Fileable Signable
Other-Pre-Focus Group Survey			Attachment G- Pre-Focus Group Survey_5.11.23.docx		Yes	Yes	Fillable Printable
Other-Focus Group Guide			Attachment H- Focus Group Guide_5.11.23.docx		No		Printable Only
Other-Focus Group Stimuli			Attachment H2- Focus Group Stimuli_4.21.23.pptx		Yes	No	Printable Only
Other-CHarM Stimuli			Attachment H3- FDA_CTP_CHarM Stimuli_5.11.23.pdf		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: 8,000	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	8,000	0	8,000	0	0	0
Annual IC Time Burden (Hours)	642	0	642	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Gen IC Memo	OMB Gen IC Memo_CHarM Study_5.11.23.docx	06/01/2023
IRB Correspondence for MOD	IRB Correspondence_for_MOD00001784.pdf	06/01/2023
IRB Correspondence for Study	IRB Correspondence_for_STUDY00022352.pdf	06/01/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.