Information Collection

KAB for Antibiotic Use, Focus Groups about Down Syndrome, and Focus Groups about CigaretteSmoking and Birth Defects

IC 192429 under ICR 200807-0920-007 · OMB 0920-0798.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0798 can be found here:

2010-11-17 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
KAB for Antibiotic Use, Focus Groups about Down Syndrome, and Focus Groups about CigaretteSmoking and Birth Defects	Form
Focus Groups about Women's Perception of Down Syndrome - Attachment 2.doc	Form
Focus Group about Women's Perception of Down Syndrome - Attachment 4.doc	Form
Focus Group about Women's Perception of Down Syndrome - Attachment 3.doc	Form
Focus Group about Women's Perception of Down Syndrome - Attachment 7.doc	Form
KAB for Antibiotic Use - prescreener OMBAttachment 1 - Pre-Screener.doc	Form
KAB for Antibiotic Use - screener OMB Att 2 - Recruitment Specs and Screening-Invitation Instr.doc	Form
KAB for Antibiotic Use - discussion guides OMB Attachment 5 - Discussion Guides.doc	Form
Focus Group about Cigarette Smoking during Pregnancy - f Attachment 2.doc	Form
Focus Group about Cigarette Smoking during Pregnancy - p Attachment 3.doc	Form
Focus Group about Cigarette Smoking during Pregnancy - s Attachment 4.doc	Form
Focus Group about Cigarette Smoking during Pregnancy - c Attachment 7.doc	Form
Attachment 5.doc Focus Group about Women's Percpetion of Down Syndrome - confirmation letter	IC Document
Attachment 1.pdf Focus Group about Women's Perception of Down Syndrome - authorizing legislation	IC Document
Attachment 6.pdf Focus Group about Women's Perception of Down Syndrome - incentive letters	IC Document
Attachment 8.pdf Focus Group about Women's Perception of Down Syndrome - IRB approval	IC Document
Project 4 OMB Ap SecA.doc Focus Group about Women's Perception of Down Syndrome - supporting statement	IC Document
OMB Attachment 3 - CAT blurb 9-1-09.doc KAB on Antibiotic Use - CAT Focus Group Information Sheet	IC Document
Attachment 1.pdf Focus Group about Cigarette Smoking during Pregnancy - legislative authority	IC Document
Attachment 5.doc Focus Group about Cigarette Smoking during Pregnancy - confirmation letter	IC Document
Attachment 6.pdf Focus Group about Cigarette Smoking during Pregnancy - incentive letters	IC Document
Attachment 8.pdf Focus Group about Cigarette Smoking during Pregnancy - IRB approval	IC Document
Project 5 OMB Ap SecA.doc Focus Group about Cigarette Smoking during Pregnancy - supporting statement	IC Document
OMB Attachment 4 Participant Information.doc KAB on Antibiotic Use - participant information	IC Document
OMB Application for Get Smart ADE project 12-7-09A.doc KAB on Antibiotic Use - supporting statement	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

KAB for Antibiotic Use, Focus Groups about Down Syndrome, and Focus Groups about CigaretteSmoking and Birth Defects

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	none	Focus Groups about Women's Perception of Down Syndrome - focus group guide	Attachment 2.doc	No	No	Paper Only
Form	none	Focus Group about Women's Perception of Down Syndrome - screener	Attachment 4.doc	No	No	Paper Only
Form	none	Focus Group about Women's Perception of Down Syndrome - questionnaire	Attachment 3.doc	No	No	Paper Only
Form	none	Focus Group about Women's Perception of Down Syndrome - consent	Attachment 7.doc	No	No	Paper Only
Form	none	KAB for Antibiotic Use - prescreener	OMBAttachment 1 - Pre-Screener.doc	No	No	Paper Only
Form	none	KAB for Antibiotic Use - screener	OMB Att 2 - Recruitment Specs and Screening-Invitation Instr.doc	No	No	Paper Only
Form	none	KAB for Antibiotic Use - discussion guides	OMB Attachment 5 - Discussion Guides.doc	No	No	Paper Only
Form	none	Focus Group about Cigarette Smoking during Pregnancy - focus group guide	Attachment 2.doc	No	No	Paper Only
Form	none	Focus Group about Cigarette Smoking during Pregnancy - participant questionnaire	Attachment 3.doc	No	No	Paper Only
Form	none	Focus Group about Cigarette Smoking during Pregnancy - screener	Attachment 4.doc	No	No	Paper Only
Form	none	Focus Group about Cigarette Smoking during Pregnancy - consent	Attachment 7.doc	No	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,252

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 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	3,252	0	0	0	0	0
Annual IC Time Burden (Hours)	761	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Focus Group about Women's Percpetion of Down Syndrome - confirmation letter	Attachment 5.doc	03/08/2010
Focus Group about Women's Perception of Down Syndrome - authorizing legislation	Attachment 1.pdf	03/08/2010
Focus Group about Women's Perception of Down Syndrome - incentive letters	Attachment 6.pdf	03/08/2010
Focus Group about Women's Perception of Down Syndrome - IRB approval	Attachment 8.pdf	03/08/2010
Focus Group about Women's Perception of Down Syndrome - supporting statement	Project 4 OMB Ap SecA.doc	03/08/2010
KAB on Antibiotic Use - CAT Focus Group Information Sheet	OMB Attachment 3 - CAT blurb 9-1-09.doc	03/15/2010
Focus Group about Cigarette Smoking during Pregnancy - legislative authority	Attachment 1.pdf	03/18/2010
Focus Group about Cigarette Smoking during Pregnancy - confirmation letter	Attachment 5.doc	03/18/2010
Focus Group about Cigarette Smoking during Pregnancy - incentive letters	Attachment 6.pdf	03/18/2010
Focus Group about Cigarette Smoking during Pregnancy - IRB approval	Attachment 8.pdf	03/18/2010
Focus Group about Cigarette Smoking during Pregnancy - supporting statement	Project 5 OMB Ap SecA.doc	03/18/2010
KAB on Antibiotic Use - participant information	OMB Attachment 4 Participant Information.doc	03/22/2010
KAB on Antibiotic Use - supporting statement	OMB Application for Get Smart ADE project 12-7-09A.doc	03/22/2010

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