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[NCEZID] (genIC) Healthcare Provider Communication Evaluation: Assessing Foodborne Illness and Waterborne Illness Prevention Messages, Knowledge, and Attitudes 0920-1154-24CU
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1154 Screening/Eligibility Form for Interviews/Focus Groups (24CU) Attachment #1 - HCP Eligibility Screener.docx Yes No Fillable Fileable
Form and Instruction 0920-1154 Eligible Participant Screener (24CU) Attachment #3 - HCP Eligible Participant Screener.docx Yes No Fillable Fileable
Form and Instruction 0920-1154 Moderator or Interviewer Guide (24CU) Attachment #8 - HCP Interview Guide.docx Yes No Fillable Fileable
Form and Instruction 0920-1154 MESSAGES to be TESTED (24CU) Attachment #9- messages to be tested HCP.docx No   Paper Only

Health Public Health Monitoring

 

360 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested 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 360 0 0 0 0 360
Annual IC Time Burden (Hours) 69 0 0 0 0 69
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA (24CU) Supporting Statement A.docx 02/06/2024
SSB (24CU) Supporting Statement B.docx 02/06/2024
Request for genIC Approval CDC/ATSDR Formative Research and Tool Development (24CU) GenIC Request_.docx 02/06/2024
Recruitment Materials (24CU) Attachment #2 - Recruitment Materials.docx 02/06/2024
Privacy Agreement_Project Staff (24CU) Attachment #4 - Privacy Agreement.docx 02/06/2024
Respondent Consent Form (24CU) Attachment #5 - Respondent Consent Form.docx 02/06/2024
Invitation_Standard (24CU) Attachment #6 - Standard Invitation.docx 02/06/2024
Participant Confirmation Email (24CU) Attachment #7 - Participant Confirmation Email.docx 02/06/2024
Determination of Non-applicability of Human Subjects Regulations (24CU) Attachment #10- Human Subjects Determination.pdf 02/06/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.