Information Collection Request

24-hour Dietary Recall Comparison Study and National Cancer Institute Validation and Observational Feeding Study (NCI)

ICR 200908-0925-001 · OMB 0925-0605 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 11 Demographic-Health Questionnaire Feeding Study Form and Instruction New Available
Form 5 ASA24 Form and Instruction New Available
Form 1 AMPM Form and Instruction New Available
Form 8 Telephone Call Form and Instruction New Available
Form 7 Screen Script Form and Instruction New Available
Form 6 Preference Survey Form and Instruction New Available
Form 5 Demographic-Health Qx - Comparison Study Form and Instruction New Available
Form 2 ASA24 Form and Instruction New Available
Form 3 AMPM Form and Instruction New Available
Form 2 Screener Comparison Study Form and Instruction New Available
Form 1 Comparison Study Screenshot Information and Consent Form and Instruction New Available
SSB_ASA24_8-3-09.doc Supporting Statement B Uploaded 2009-08-03 Available
Attach17 - IRB Approval.doc Supplementary Document Uploaded 2009-08-03 Available
Attach16 - Privacy Act Memo.doc Supplementary Document Uploaded 2009-08-03 Available
Attach15 - Observational feeding study thank you letter.doc Supplementary Document Uploaded 2009-08-03 Available
Attach14 - 24HR comparison study thank you letter.doc Supplementary Document Uploaded 2009-08-03 Available
Attach13 - ASA24 External Working Group Members.doc Supplementary Document Uploaded 2009-08-03 Available
Attach11 - Observational feeding informed consent.doc Supplementary Document Uploaded 2009-08-03 Repair queued
Attach3 - 24HR comparison invitation Letter_ final.doc Supplementary Document Uploaded 2009-08-03 Available
Cover Memo_ASA24_7-31-09.doc Supplementary Document Uploaded 2009-07-31 Available
SSA_ASA24_8-3-09.doc Supporting Statement A Uploaded 2009-08-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
190241 Demographic-Health Questionnaire Observational Feeding Study Form and Instruction NewDemographic-Health Questionnaire Feeding Study
190240 AMPM or ASA24 Dietary Recall Form and Instruction NewASA24
190240 AMPM or ASA24 Dietary Recall Form and Instruction NewAMPM
190239 Eating 3 Meals Instruction New
190238 Reminder Telephone Call - Observational Feeding Study Form and Instruction NewTelephone Call
190237 Screening Script - Observational Feeding Study Form and Instruction NewScreen Script
190236 Preference Survey - 24HR Dietary Recall Comparison Study Form and Instruction NewPreference Survey
190235 Demographic-Health Questionnaire - 24HR Dietary Recall Comparison Study Form and Instruction NewDemographic-Health Qx - Comparison Study
190234 ASA24 Screenshots Form and Instruction NewASA24
190233 Automated Multiple Pass Method (AMPM) Form and Instruction NewAMPM
190232 Screening Script - 24HR Recall Comparison Study Form and Instruction NewScreener Comparison Study
190231 24HR Recall Comparison Study Screenshots of Information and Consent Form and Instruction NewComparison Study Screenshot Information and Consent

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2011 24 Months From Approved
3,499 0 0
1,054 0 0
0 0 0





Reginfo record details
11
table that charts list of burden
IC Title Form No. Form Name
24HR Recall Comparison Study Screenshots of Information and Consent 1
AMPM or ASA24 Dietary Recall 1, 5 ,  
ASA24 Screenshots 2
Automated Multiple Pass Method (AMPM) 3
Demographic-Health Questionnaire - 24HR Dietary Recall Comparison Study 5
Demographic-Health Questionnaire Observational Feeding Study 11
Eating 3 Meals
Preference Survey - 24HR Dietary Recall Comparison Study 6
Reminder Telephone Call - Observational Feeding Study 8
Screening Script - 24HR Recall Comparison Study 2
Screening Script - Observational Feeding Study 7

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,499 0 0 3,499 0 0
Annual Time Burden (Hours) 1,054 0 0 1,054 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No