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Underage Alcohol Use Prevention Media Campaign Focus Groups
Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages
OMB: 0930-0196
IC ID: 192336
OMB.report
HHS/SAMHSA
OMB 0930-0196
ICR 200706-0930-004
IC 192336
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:
2022-03-25 - Reinstatement without change of a previously approved collection
2016-08-25 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Attachment 3 - Mal
Underage Alcohol Use Prevention Media Campaign Focus Groups
Form
Attachment 3 - Mal Attachment 3 - Male Screener
Attachment3 Male Recruit-Screener 3-18-10_Final.doc
Form
Attachment 2 - Fem Attachment 2 - Female Screener
Attachment2 Female Recruit-Screener 3-18-10_Final.doc
Form
Attachment6 Use of Telephone Focus Groups 3-15-10_Final.pdf
Attachment 6 - Use of Telephone Focus Groups
IC Document
Attachment5 Message Concepts for Testing 3-18-10_Final.doc
Attachment 5 - Message Concepts
IC Document
Attachment4 Focus Group Moderator Guide 3-18-10_Final.doc
Attachment 4 - Moderator's Guide
IC Document
Attachment1 Focus Group Plan 3-18-10_Final.doc
Attachment 1 - Focus Group Plan
IC Document
Terms of Clearance 0930-0196_Underage Alcohol Use Prevention Media Campaign Focus Groups.doc
Terms of Clearance
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Underage Alcohol Use Prevention Media Campaign Focus Groups
Agency IC Tracking Number:
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
Attachment 3 - Male Screener
Attachment 3 - Male Screener
Attachment3 Male Recruit-Screener 3-18-10_Final.doc
Yes
Yes
Paper Only
Form
Attachment 2 - Female Screener
Attachment 2 - Female Screener
Attachment2 Female Recruit-Screener 3-18-10_Final.doc
Yes
Yes
Paper 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:
600
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
72
0
72
0
0
0
Annual IC Time Burden (Hours)
102
0
102
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 6 - Use of Telephone Focus Groups
Attachment6 Use of Telephone Focus Groups 3-15-10_Final.pdf
03/18/2010
Attachment 5 - Message Concepts
Attachment5 Message Concepts for Testing 3-18-10_Final.doc
03/18/2010
Attachment 4 - Moderator's Guide
Attachment4 Focus Group Moderator Guide 3-18-10_Final.doc
03/18/2010
Attachment 1 - Focus Group Plan
Attachment1 Focus Group Plan 3-18-10_Final.doc
03/18/2010
Terms of Clearance
Terms of Clearance 0930-0196_Underage Alcohol Use Prevention Media Campaign Focus Groups.doc
04/13/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.