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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NCCDPHP]: Focus Group Testing to Effectively Plan and Tailor a CP&C Communication Campaign (Bring your Brave)
Agency IC Tracking Number:
0920-0800-24HA
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
Form and Instruction
0920-0800
Focus Group Screener
Attachment 1_ Focus Group Screener.docx
Yes
Yes
Fillable Fileable
Instruction
Attachment 2_ Focus Group Consent Form.docx
Yes
Yes
Printable Only
Instruction
Attachment 3_ Participant Information Slide Deck.pptx
Yes
Yes
Printable Only
Instruction
Attachment 4_ Focus Group Discussion Guide.docx
No
Printable Only
Instruction
Attachment 5_ Materials for Testing-2.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
192
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
192
0
192
0
0
0
Annual IC Time Burden (Hours)
176
0
176
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA (24HA)
Supporting Statement A.docx
06/28/2024
SSB (24HA)
Supporting Statement B.docx
06/28/2024
Authorizing Legislation
Attachment 6_ Section 301 of Public Health Services Act.docx
06/28/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.