Information Collection

Assessment of Communication Messages and Materials

IC 192335 under ICR 200802-0925-003 · OMB 0925-0590.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0590 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Assessment of Communication Messages and Materials	Form
1 Focus Group Screener Attachment C - Screening Instrument for Focus Groups.docx	Form
2 Focus Group Guide Attachment A - Moderators Guide for Focus Groups.docx	Form and Instruction
3 Interview Screener Attachment D - Screening Instrument for Interviews.docx	Form
4 Interview Guidelines Attachment B - Semi-structured Interview Protocol.docx	Form and Instruction
NCS Mssg Focus Group Protocol_Mini Supporting Statement_3-22-10.docx NCS Mssg Focus Group Protocol_Mini Supporting Statement_3-22-10	IC Document
Attachment E - Informed Consent.docx Attachment E - Informed Consent	IC Document
Terms of Clearance_0925-0590 communications.docx Terms of Clearance	IC Document

IC Title:

Assessment of Communication Messages and Materials

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Focus Group Screener	Attachment C - Screening Instrument for Focus Groups.docx	Yes	Yes	Paper Only
Form and Instruction	2	Focus Group Guide	Attachment A - Moderators Guide for Focus Groups.docx	Yes	Yes	Paper Only
Form	3	Interview Screener	Attachment D - Screening Instrument for Interviews.docx	Yes	Yes	Paper Only
Form and Instruction	4	Interview Guidelines	Attachment B - Semi-structured Interview Protocol.docx	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 848

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	848	848
Annual IC Time Burden (Hours)	359	359
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NCS Mssg Focus Group Protocol_Mini Supporting Statement_3-22-10	NCS Mssg Focus Group Protocol_Mini Supporting Statement_3-22-10.docx	03/22/2010
Attachment E - Informed Consent	Attachment E - Informed Consent.docx	03/22/2010
Terms of Clearance	Terms of Clearance_0925-0590 communications.docx	05/06/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.