Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)

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⚠️ Notice: This information collection may be referencing outdated material.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
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO) Form
Screener in English and Spanish ATTACHMENT_D-Participant_Screening_Instrument.docx Form
Dicussion Guide in English and Spanish ATTACHMENT_C-Discussion_Guide.docx Form
ATTACHMENT_E-Participant_Information_Sheet.docx Participant Information Sheet IC Document
ATTACHMENT_F-Breaking_News_Script.docx News Script IC Document
ATTACHMENT_G_Materials_for_Testing.pptx Materials for Testing IC Document
ATTACHMENT_B-Full_Protocol.docx Full Protocol IC Document
ATTACHMENT_A-Protocol_Summary.docx Protocol Summary IC Document
Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf Expedited Review Form IC Document

Information Collection (IC) Details

IC Title:	Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)	Agency IC Tracking Number:	14AHO

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Screener in English and Spanish	ATTACHMENT_D-Participant_Screening_Instrument.docx		No		Paper Only
Form	none	Dicussion Guide in English and Spanish	ATTACHMENT_C-Discussion_Guide.docx		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	351	351
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Participant Information Sheet	ATTACHMENT_E-Participant_Information_Sheet.docx	06/16/2014
News Script	ATTACHMENT_F-Breaking_News_Script.docx	06/16/2014
Materials for Testing	ATTACHMENT_G_Materials_for_Testing.pptx	06/16/2014
Full Protocol	ATTACHMENT_B-Full_Protocol.docx	06/16/2014
Protocol Summary	ATTACHMENT_A-Protocol_Summary.docx	06/16/2014
Expedited Review Form	Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf	06/16/2014

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