Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG)

Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns--New

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0800 can be found here:

Documents and Forms

Document Name Document Type
Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG) Form
Recruitment App D_Recruitment Form_5 21 2014.doc Form
Focus Group Guide App C_Focus Group Guide_5 23 2014.docx Form
SSA_5 23 2014.doc Supporting Statement Part A IC Document
SSB_5 23 2014.doc Supporting Statement Part B IC Document
App B_Consent_5 21 2014.doc Consent Form IC Document
App A1_PHSA.DOCX Authorizing Legislation Part 1 IC Document
App A2_Johannas Law.pdf Authorizing Legislation Part 2 IC Document
IRB IK_NCCCP_684.pdf IRB IC Document

Information Collection (IC) Details

IC Title:	Assessing the Uptake and Effectiveness of Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign (14AFG)	Agency IC Tracking Number:	14AFG

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 247b-17 42 CFR 241 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Recruitment	App D_Recruitment Form_5 21 2014.doc		No		Paper Only
Form	none	Focus Group Guide	App C_Focus Group Guide_5 23 2014.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,800	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	1,800	1,800
Annual IC Time Burden (Hours)	1,240	1,240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement Part A	SSA_5 23 2014.doc	06/02/2014
Supporting Statement Part B	SSB_5 23 2014.doc	06/02/2014
Consent Form	App B_Consent_5 21 2014.doc	06/02/2014
Authorizing Legislation Part 1	App A1_PHSA.DOCX	06/02/2014
Authorizing Legislation Part 2	App A2_Johannas Law.pdf	06/02/2014
IRB	IRB IK_NCCCP_684.pdf	06/02/2014

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