OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

HIV Testing Factors among Rural Black Men and Family and Cultural Impact on STD and HIV Risk among Latino and African-American Youth

IC 195746 under ICR 200910-0920-004 · OMB 0920-0840.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Form
Form
Form
Form
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

HIV Testing Factors among Rural Black Men and Family and Cultural Impact on STD and HIV Risk among Latino and African-American Youth
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener - Testing in Rural Black Men Att_1a_Screening and Contact Form.docx Yes Yes Fillable Fileable
Form none Adolescent survey - Family and Cultural Impact Att_1e_ACASI Survey-Youth.docx Yes Yes Fillable Fileable
Form none Survey - Testing in Rural Black Men Att_1b_Survey Instrument.docx Yes Yes Fillable Fileable
Form none Focus group guide - Testing in Rural Black Men Att_1c_Focus Group Guide.10012010.docx Yes Yes Fillable Fileable
Form none Focus group guide - Family and Cultural Impact Att_1c_Focus Group Guide.docx Yes Yes Fillable Fileable
Form none Focus group screener - Family and Cultural Impact Att_1a_Focus Group Screener.docx Yes Yes Fillable Fileable
Form none Survey screener - Family and Cultural Impact Att_1b_Survey Screener.docx Yes Yes Fillable Fileable
Form none Adult survey - Family and Cultural Impact Att_1d_ ACASI Survey-Parents.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

3,858 0
   
Individuals or Households
 
   100 %

  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 3,858 0 0 0 0 0
Annual IC Time Burden (Hours) 2,310 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement - Testing in Rural Black Men Brown_SS_SectA.OCT20.docx 12/13/2010
Local IRB Approval - Testing in Rural Black Men Att_4b_Local IRB Approval.pdf 12/13/2010
Local IRB Approval - Testing in Rural Black Men Att_4c_Local IRB Approval.pdf 12/13/2010
CDC Research Determination - Testing in Rural Black Men Att_4a_CDC Determination.pdf 12/13/2010
Recruitment Flyer - Testing in Rural Black Men Att_3a_Recruitment Flyer.10012010.docx 12/13/2010
Recruitment Script - Testing in Rural Black Men Att_3b_Recruitment Script.10012010.docx 12/13/2010
Survey Consent -Testing in Rural Black Men Att_2a_Survey Consent.10012010.docx 12/13/2010
Focus Group Consent - Testing in Rural Black Men Att_2b_Focus Group_Consent.10012010.docx 12/13/2010
Supporting Statement - Family and Cultural Impact SS_Part A.docx 12/13/2010
CDC determination - Family and Cultural Impact Att_3a_Project Determination-CDC.docx 12/13/2010
Local IRB - Family and Cultural Impact Att_3b_Local IRB Determination.docx 12/13/2010
Focus group recruitment flyer - Family and Cultural Impact Att_4a_Focus Group Recruitment Flyer.docx 12/13/2010
Focus group recruitment script - Family and Cultural Impact Att_4b_Focus Group Recruitment Script.docx 12/13/2010
Survey recruitment script - Family and Cultural Impact Att_4d_Survey Recruitment Script.docx 12/13/2010
Survey recruitment flyer - Family and Cultural Impact Att_4c_Survey Recruitment Flyer.docx 12/13/2010
Focus group consent - Family and cultural impact Att_2a_ Focus Group Consent.docx 12/13/2010
Adult survey consent - Family and Cultural Impact Att_2b_Adult Survey Consent.docx 12/13/2010
Adoloescent survey assent - Family and Cultural Impact Att_2c_Adolescent Survey Assent .docx 12/13/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.