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View Information Collection (IC)

[PHIC/NCEZID] Use and Acceptability of the Model Aquatic Health Code (2024)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0879 MAHC Use and Acceptability Survey (EpiInfo Web Survey) AttB_MAHC_UA_SurveyV2.pdf https://epiinfosecurewebsurvey.cdc.gov/Survey/6efb7a91-f9b2-48c0-9013-cc370b2d6b65/1 Yes Yes Fillable Fileable
Form and Instruction 0920-0879 Focus Group Discussion Guide—Moderate MAHC Use and Implementation AttD1_FGGuide_Lim.pdf Yes No Fillable Fileable
Form and Instruction 0920-0879 Focus Group Discussion Guide—Moderate MAHC Use and Implementation AttD2_FGGuide_Mod.pdf Yes No Fillable Fileable
Form and Instruction 0920-0879 Focus Group Discussion Guide—Advanced MAHC Use and Implementation AttD3_FGGuide_Adv.pdf Yes No Fillable Fileable
Form and Instruction 0920-0879 Case Study In-Depth Interview Guide AttE_CS_IDIGuide.pdf Yes No Fillable Fileable

Health Public Health Monitoring

 

1,373 0
   
State, Local, and Tribal Governments
 
   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 1,373 0 1,373 0 0 0
Annual IC Time Burden (Hours) 706 0 706 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA MAHC_SSA_07232024_clean.docx 07/31/2024
SSB MAHC_SSB_07232024_clean.docx 07/31/2024
Algorithm for Focus Group Placement AttC_FocusGroupPlacement.pdf 07/31/2024
Survey Consent Form AttF_CS_SurveyConsentForm.pdf 07/31/2024
Survey Recruitment Email AttG1_SurveyRecEmail.pdf 07/31/2024
Survey Recruitment: Partner Listserv Email AttG2_SurveyRec_PtListserv.pdf 07/31/2024
Survey Reminder Email AttG3_SurveyRemEmail.pdf 07/31/2024
Survey Snowball Sampling Recruitment Email AttH_SnSamRecEmail.pdf 07/31/2024
Focus Group Invitation Email AttI1_FGInvEmail.pdf 07/31/2024
Focus Group Confirmation Email AttI2_FGConfirmationEmail.pdf 07/31/2024
Focus Group Reminder Email AttI3_FGReminderEmail.pdf 07/31/2024
Focus Group Consent Form AttJ_FGConsent.pdf 07/31/2024
Case Study Recruitment Email AttK1_CSRecEmail.pdf 07/31/2024
Case Study Confirmation Email AttK2_CSConfEmail.pdf 07/31/2024
Case Study Consent Form AttL_CSConsent.pdf 07/31/2024
Determination of Non-applicability of Human Subjects Regulations MAHC_STARS_03072024.pdf 07/31/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.