Information Collection Request

Formative Research to Inform an HIV Testing Social Marketing Campaign for African American Heterosexual Men

ICR 200909-0920-011 · OMB 0920-0762 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0762_Sup Stat B_081709.doc Supporting Statement B Uploaded 2009-08-31 Available
0762_Att5.CDC and RTI IRB _081709.doc Supplementary Document Uploaded 2009-08-31 Available
0762_Att4.Consent Forms_081709.doc Supplementary Document Uploaded 2009-08-31 Repair queued
0762_Att2.60dFRN.pdf Supplementary Document Uploaded 2009-08-31 Available
0762_ Att1.Authorizing Legislation.doc Supplementary Document Uploaded 2009-08-31 Available
0762_Sup Stat A_081709.doc Supporting Statement A Uploaded 2009-08-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
182369 Data Collection Instrument for Focus Groups Other-Data Collection Instrument Removed
182368 Data Collection Instrument for Interviews Other-WORD Modified
182367 Paper and Pencil Questionnaire Other-WORD Modified
182366 Study Screener Other-WORD Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2012 36 Months From Approved 01/31/2011
576 0 297
228 0 146
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Data Collection Instrument for Focus Groups
Study Screener
Paper and Pencil Questionnaire
Data Collection Instrument for Interviews

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 576 297 0 279 0 0
Annual Time Burden (Hours) 228 146 0 82 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No