Focus Groups Involving Children Moderator's Guide

Formative Evaluation of Adults' and Children's Views Related to Promotion of Healthy Food Choices

Documents and Forms

Document Name Document Type
Appendix F Mod Guide for Children.doc Other-Children's/Youth Focus Groups
Appendix E2 Parental Permission.doc Parental Permission Form IC Document
Appendix E3 Youth Assent.doc Youth Assent Form IC Document

Information Collection (IC) Details

IC Title:	Focus Groups Involving Children Moderator's Guide	Agency IC Tracking Number:

Is this a Common Form? No		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
Other-Children's/Youth Focus Groups Discussion Outline			Appendix F Mod Guide for Children.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 384	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	384	384
Annual IC Time Burden (Hours)	768	768
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Parental Permission Form	Appendix E2 Parental Permission.doc	03/31/2008
Youth Assent Form	Appendix E3 Youth Assent.doc	03/31/2008

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