Information Collection

An Assessment of Rural and Uninsured Consumer Perspectives on Cancer and Related Communications: A Focus Group Study (Sub-Study #16)

IC 190259 under ICR 200810-0925-002 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 An Assessment of Rural and Uninsured Consumer Perspectives on Cancer and Related Communications: A Focus Group Study (Sub-Study #16)	Form and Instruction
2A Moderator's Guide_No Cancer_Sub-study #16 Attach B_Mod Guide_NO Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc	Form and Instruction
2B Moderator's Guide_With Cancer_Sub-study #16 Attach C_Mod Guide_WITH Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc	Form and Instruction
1 Screener_Sub-study #16 Attach A_Screener_Rural and Insurance Status Focus Groups 7 23 09.doc	Form and Instruction
Attach D_ Research Design_NCI Rural_Insurance FGs.docx Research Design	IC Document
GC Sub-Study Summary Form_0925-0046-16.doc GC Summary Form	IC Document
Attach E_Recruitment Charts_NCI Rural_Insurance FGs.docx Recruitment Charts	IC Document
Justification Memo Rural and Uninsured Focus Groups_ 7 15 09.doc Justification Memo Sub-Study #16	IC Document
REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09.docx REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09	IC Document
Attach F_Informed Consent Rural and Uninsured Consumer.docx Attach F_Informed Consent Rural and Uninsured Consumer	IC Document

IC Title:

An Assessment of Rural and Uninsured Consumer Perspectives on Cancer and Related Communications: A Focus Group Study (Sub-Study #16)

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 and Instruction	1	Screener_Sub-study #16	Attach A_Screener_Rural and Insurance Status Focus Groups 7 23 09.doc	Yes	Yes	Printable Only
Form and Instruction	2A	Moderator's Guide_No Cancer_Sub-study #16	Attach B_Mod Guide_NO Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc	Yes	Yes	Printable Only
Form and Instruction	2B	Moderator's Guide_With Cancer_Sub-study #16	Attach C_Mod Guide_WITH Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 192

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	192	0	0	0	0	0
Annual IC Time Burden (Hours)	480	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
Research Design	Attach D_ Research Design_NCI Rural_Insurance FGs.docx	07/15/2009
GC Summary Form	GC Sub-Study Summary Form_0925-0046-16.doc	07/15/2009
Recruitment Charts	Attach E_Recruitment Charts_NCI Rural_Insurance FGs.docx	07/15/2009
Justification Memo Sub-Study #16	Justification Memo Rural and Uninsured Focus Groups_ 7 15 09.doc	07/23/2009
REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09	REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09.docx	10/16/2009
Attach F_Informed Consent Rural and Uninsured Consumer	Attach F_Informed Consent Rural and Uninsured Consumer.docx	10/16/2009

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