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

View Information Collection (IC)

[OADC] Developing and Testing New Infographics for Health Equity 0920-0572-24DH
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0572 General Population Screening Questionnaire Attachment 2-General Population Screening Questionnaire_v2.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0572 Screening Questionnaire Attachment 3-Professional Screening Questionnaire_v2.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0572 General Population Quantitative Testing Instrument Attachment 5-General Population Quantitative Testing Instrument_v2.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0572 Public Health Professionals Quantitative Testing Instrument Attachment 6-Public Health Professionals Quantitative Testing Instrument_v2.docx Yes Yes Fillable Fileable
Form 0920-0572 Qualitative Focus Group Discussion Guide – All Audiences Attachment 7-Qualitative Focus Group Discussion Guide_All Audiences.docx No   Paper Only

Health Public Health Monitoring

 

1,200 0
   
Individuals or Households
 
   50 %

  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 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 480 0 480 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HMTS Expedited Review Form OHE_Health Equity Infographics-HMTS Expedited Review Form.docx 02/28/2024
Communications Materials Testing Plan Attachment 1-Communications Materials Testing Plan.docx 02/28/2024
Professional Recruitment Message Templates Attachment 4-Professional Recruitment Message Templates.docx 02/29/2024
Social Determinants of Health Attachment 8-Health Equity Infographics for Testing.pdf 02/29/2024
Informed Consent Form (Online Survey) Attachment 9-Quantitative Data Collection Informed Consent Form.docx 02/29/2024
Informed Consent Form (Focus Group) Attachment 10-Qualitative Data Collection Informed Consent Form.docx 02/29/2024
Attachment List Health Equity Infographic Testing Attachment Guide.docx 02/29/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.