Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing

CDC and ATSDR Health Message Testing System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Document Name Document Type
Attachment 2_Eligibility Screener 08 13 13v3.docx Other-Word
Attachment 3_Interview Protocol 08 13 13v3.docx Other-Word
Attachment 4_Messages for Testing 08 13 13.docx Other-Word
Attachment 1_Research Plan - Burden Table 08 13 13v3.docx Attachment 1_Research Plan - Burden Table 08 13 13v3 IC Document
HMTS Expedited Review Form 08 13 13v3.docx HMTS Expedited Review Form 08 13 13v3 IC Document
List of Attachments 08 8 13.docx List of Attachments 08 8 13 IC Document

Information Collection (IC) Details

IC Title:	Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Word	Attachment 2_Eligibility Screener 08 13 13v3.docx	Yes	Yes	Fillable Printable
Other-Word	Attachment 3_Interview Protocol 08 13 13v3.docx	Yes	Yes	Fillable Printable
Other-Word	Attachment 4_Messages for Testing 08 13 13.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	60	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 1_Research Plan - Burden Table 08 13 13v3	Attachment 1_Research Plan - Burden Table 08 13 13v3.docx	09/25/2013
HMTS Expedited Review Form 08 13 13v3	HMTS Expedited Review Form 08 13 13v3.docx	09/25/2013
List of Attachments 08 8 13	List of Attachments 08 8 13.docx	09/25/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.