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Demonstration Project of HCV Rapid Testing in HIV Testing Settings and Development of Recruitment Strategies for the Web-based HIV Behavioral Survey among MSM

IC 201422 under ICR 200910-0920-004 · OMB 0920-0840.

Documents and Forms
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Form and Instruction
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IC Document
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IC Document
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Information Collection (IC) Details

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Demonstration Project of HCV Rapid Testing in HIV Testing Settings and Development of Recruitment Strategies for the Web-based HIV Behavioral Survey among MSM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none HCV Testing - Denver screener Att_5a_Denver AlertHealth Screening and Contact Form 02222012.doc No No Paper Only
Form none Recruitment - 1a Screener Att 1a_Eligibility Screener_Focus Group.docx Yes Yes Fillable Fileable
Form and Instruction none HCV Testing - Focus Group Guide Att_1a_Interview and Focus Group Guide.docx No No Paper Only
Form none HCV Testing - Screener Att_5b_Community Health Awareness Group Screening and Contact Form.doc No No Paper Only
Form none Recruitment - 1b Focus Group Interview Att 1b_Focus Group Interview.docx Yes Yes Fillable Fileable
Form none Recruitment - 1c Screener Att 1c Eligibility Screener_Web-based survey.docx Yes Yes Fillable Fileable
Form none Recruitment - 1d Web Survey Att 1d Web-based survey.docx Yes Yes Fillable Fileable
Form none Recruitment - 3a Spanish Screener Att 3a Eligibility Screener (Spanish).docx Yes Yes Fillable Fileable
Form none Recruitment - 3b Spanish Survey Att 3b Behavioral Assessment Survey (Spanish).docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

15,156 0
   
Individuals or Households
 
   95 %

  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 15,156 0 0 0 0 0
Annual IC Time Burden (Hours) 2,104 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HCV Testing - Supporting Statement A SupportinStatement A.docx 02/29/2012
Recruitment - Supporting Statement A Supporting Statement - Part A.docx 02/29/2012
HCV Testing - 4b MI IRB Att_4b_Local IRB Approval - Wayne State Univ IRB.pdf 02/29/2012
HIV Testing - 4a CO IRB Att_4a_Local IRB Approval - Colorado IRB.pdf 02/29/2012
HIV Testing - 2c - Info Sheet Att_2c_Staff and Client Interview and Focus Group Information Sheet.doc 02/29/2012
HIV Testing - 2a Staff Consent Att_2a_Staff Interview and Focus Group Consent 02222012.doc 02/29/2012
HCV Testing - 2b Client Consent Att_2b_Client Interview and Focus Group Consent 02222012.doc 02/29/2012
HCV Testing - 3b Fact sheet Att_3b_Fact Sheet Living with Chronic Hepatitis C.doc 02/29/2012
HCV Testing - 3a Fact Sheet Att_3a_Fact Sheet Info about Testing Hep C.doc 02/29/2012
Recruitment - Supporting Statement B Supporting Statement - Part B.docx 02/29/2012
Recruitment - 2a Consent Att 2a Consent_focus group.docx 02/29/2012
Recruitment - 2b Web Consent Att 2b_Consent_web-based survey.docx 02/29/2012
Recruitment - Survey screenshots Att 1h Screen Shots of Survey.pdf 02/29/2012
Recruitment - 3 IRB Letter Att 3 Emory IRB Approval Letter.pdf 02/29/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.