Sub-study #4: Cognitive Testing of the Family Life, Activity, Sun, Health, and Eating (FLASHE) Survey

Questionnaire Cognitive Interviewing and Pretesting (NCI)

OMB: 0925-0589

IC ID: 202800

Information Collection (IC) Details

View Information Collection (IC)

Sub-study #4: Cognitive Testing of the Family Life, Activity, Sun, Health, and Eating (FLASHE) Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 FLASHE Screener Attach 4F Screener.docx No No Printable Only
Form and Instruction 2 Parent Diet and Demographic Survey Attach 4A-1 FLASHE Parent Diet And Demographics Survey.doc No No Printable Only
Form and Instruction 3 Parent Physical Activity Survey and Checklist Attach 4A-2 FLASHE Parent PA Survey and Activity Checklist.pdf No No Printable Only
Form and Instruction 4 Teen Diet and Demographic Survey Attach 4A-3 FLASHE Teenager Diet and Demographics Survey.doc No No Printable Only
Form and Instruction 5 Teen Physical Activity Survey and Recall Attach 4A-4 FLASHE Teenager PA Survey and Activity Recall.pdf No No Printable Only
Form and Instruction 6 Parent Cognitive Interview Guide Attach 4B-1 and 4B-2 Parent Cognitive Interview Guide.docx No No Printable Only
Form and Instruction 7 Teen Cognitive Interview Guide Attach 4B-3 and 4B-4 Teenager Cognitive Interview Guide.docx No No Printable Only

Health Consumer Health and Safety

Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD  67 FR 60743

80 0
   
Individuals or Households
 
   0 %

  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 80 0 0 0 0 0
Annual IC Time Burden (Hours) 63 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Gen IC Summary Generic Sub-Study Form.doc 05/22/2012
Justification Memo Justification Memo.doc 05/22/2012
Attach 4C Informed Consent Forms - Parent and Teen Attach 4C Informed Consent Forms - Parent and Teen.docx 05/22/2012
Attach 4D Reminder Letter-Email Attach 4D Reminder Letter-Email.docx 05/22/2012
Attach 4E FLASHE Cognitive Testing Plan Attach 4E FLASHE Cognitive Testing Plan.docx 05/22/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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