Information Collection Request

Formative Research to Inform an HIV Testing Social Marketing Campaign for African American Men Who Have Sex with Men (MSM)

ICR 200911-0920-005 · OMB 0920-0762 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
requestfortitlechange0762.doc Justification for No Material/Nonsubstantive Change Uploaded 2009-11-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
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 11/30/2012 11/30/2012
576 0 576
228 0 228
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
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 576 576 0 0 0 0
Annual Time Burden (Hours) 228 228 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No