Information Collection

Bundled Sub-Studies for HINTS (#17) and NCI Cancer Centers' Clinical Trial Accruals (#18)

IC 191499 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⚠️ Notice: This information collection may be referencing outdated material.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 2 Bundled Sub-Studies for HINTS (#17) and NCI Cancer Centers' Clinical Trial Accruals (#18)	Form and Instruction
3 #17_Att_C_HINTS Current Results User Guide #17_Att_C_HINTS Current Results User Guide 0925-0046-17.doc	Form and Instruction
2 #17_Att_B_HINTS Potential Data User Guide #17_Att_B_HINTS Potential Data User Guide 0925-0046-17.doc	Form and Instruction
1 #17_Att_A_HINTS Current Data User Guide #17_Att_A_HINTS Current Data User Guide 0925-0046-17.doc	Form and Instruction
4 #17_Att_D_HINTS Potential Results User Guide #17_Att_D_HINTS Potential Results User Guide 0925-0046-17.doc	Form and Instruction
5 #17_Att_E_HINTS Student Guide #17_Att_E_HINTS Student Guide_0925-0046-17.doc	Form and Instruction
6 #17 HINTS Screener #17_Att_G_HINTS Screener Questions 0925-0046-17.doc	Form and Instruction
1 #18_Att_ A CT Accrual Needs Assessment instrument #18_Att_ A CT Accrual Needs Assessment instrument 0925-0046-18.doc	Form and Instruction
#18_CT_ GC_Summary Sub-Study Form_0925-0046-18.doc #18_CT_ GC_Summary Sub-Study	IC Document
#18_Att_B Informed Consent Form 0925-0046-18.docx #18_Att_B CT Informed Consent Form	IC Document
#18_CT_Justification Memo CT Needs Assess Survey 0925-0046-18.doc #18_CT_Justification Memo CT Survey	IC Document
Memo to OMB_Key To Bundled Pkg..doc READ FIRST - KEY TO BUNDLED STUDY	IC Document
#17_Att_F_HINTS Invitation Email-Phone 0925-0046-17.doc #17_Att_F_HINTS Invitation Email-Phone	IC Document
#17_Att_H_HINTS Reminder Email-Phone 0925-0046-17.doc #17_Att_H_HINTS Reminder Email-Phone	IC Document
#17_Att_I_HINTS Informed Consents 0925-0046-17.doc #17_Att_I_HINTS Informed Consents	IC Document
#17_HINTS GC Summary Sub-Study_0925-0046-17.doc #17_HINTS GC Summary Sub-Study	IC Document
#17_HINTS Justification Memo_0925-0046-17.doc #17_HINTS Justification Memo	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Bundled Sub-Studies for HINTS (#17) and NCI Cancer Centers' Clinical Trial Accruals (#18)

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	2	#17_Att_B_HINTS Potential Data User Guide	#17_Att_B_HINTS Potential Data User Guide 0925-0046-17.doc	No	No	Paper Only
Form and Instruction	1	#17_Att_A_HINTS Current Data User Guide	#17_Att_A_HINTS Current Data User Guide 0925-0046-17.doc	Yes	No	Paper Only
Form and Instruction	4	#17_Att_D_HINTS Potential Results User Guide	#17_Att_D_HINTS Potential Results User Guide 0925-0046-17.doc	Yes	No	Paper Only
Form and Instruction	5	#17_Att_E_HINTS Student Guide	#17_Att_E_HINTS Student Guide_0925-0046-17.doc	Yes	No	Paper Only
Form and Instruction	6	#17 HINTS Screener	#17_Att_G_HINTS Screener Questions 0925-0046-17.doc	Yes	No	Paper Only
Form and Instruction	1	#18_Att_ A CT Accrual Needs Assessment instrument	#18_Att_ A CT Accrual Needs Assessment instrument 0925-0046-18.doc	Yes	No	Fillable Printable
Form and Instruction	3	#17_Att_C_HINTS Current Results User Guide	#17_Att_C_HINTS Current Results User Guide 0925-0046-17.doc	Yes	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service HHS/PHS/NIH/OD [09-25-0156]

FR Citation: 74 FR 55558

Number of Respondents: 369

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 53 %

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	369	0	0	0	0	0
Annual IC Time Burden (Hours)	169	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
#18_CT_ GC_Summary Sub-Study	#18_CT_ GC_Summary Sub-Study Form_0925-0046-18.doc	12/03/2009
#18_Att_B CT Informed Consent Form	#18_Att_B Informed Consent Form 0925-0046-18.docx	12/03/2009
#18_CT_Justification Memo CT Survey	#18_CT_Justification Memo CT Needs Assess Survey 0925-0046-18.doc	12/03/2009
READ FIRST - KEY TO BUNDLED STUDY	Memo to OMB_Key To Bundled Pkg..doc	12/03/2009
#17_Att_F_HINTS Invitation Email-Phone	#17_Att_F_HINTS Invitation Email-Phone 0925-0046-17.doc	12/03/2009
#17_Att_H_HINTS Reminder Email-Phone	#17_Att_H_HINTS Reminder Email-Phone 0925-0046-17.doc	12/03/2009
#17_Att_I_HINTS Informed Consents	#17_Att_I_HINTS Informed Consents 0925-0046-17.doc	12/03/2009
#17_HINTS GC Summary Sub-Study	#17_HINTS GC Summary Sub-Study_0925-0046-17.doc	12/03/2009
#17_HINTS Justification Memo	#17_HINTS Justification Memo_0925-0046-17.doc	12/03/2009

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