A Generic Submission for Theory Development and Validation (NCI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Self-Affirmation Survey Screenshots	Form and Instruction	New	Available
Form 3 Focus Group Protocol	Form and Instruction	New	Available
Form 1 Screener	Form and Instruction	New	Available
Form 2 Survey	Form and Instruction	New	Available
Form 1 Screenshots	Form and Instruction	New	Available
Form 3 Survey 3	Form and Instruction	New	Available
Form 2 Survey 2	Form and Instruction	New	Available
Form 1 Survey 1	Form and Instruction	New	Available
Form 1 Simulated Clinical Interaction Survey	Form and Instruction	New	Available
Form 2 and 3 Attachment B and D Screenshots	Form and Instruction	New	Available
Form 4 Moderator Guide & Focus Group	Form and Instruction	New	Available
Form 3 Eye Tracking Survey	Form and Instruction	New	Available
Form 5 Moderators Guide and Interview	Form and Instruction	New	Available
Form 1 Screener	Form and Instruction	New	Available
Form 2 Baseline Survey	Form and Instruction	New	Available
Form 2 Questionnaire (Screenshots)	Form and Instruction	New	Available
Form 1 Screener	Form and Instruction	New	Available
Form 1 Self-Affirm Survey	Form and Instruction	New	Available
Form 1 Self-Affirmation Survey	Form and Instruction	New	Available
SSB_BRP_Generic_Theory_10-27-2011.doc	Supporting Statement B	Uploaded 2011-10-27	Available
ATTACH 3_Experts_Theory.doc	Supplementary Document	Uploaded 2011-10-06	Available
ATTACH 2_Mission_Theory.doc	Supplementary Document	Uploaded 2011-10-06	Available
ATTACH 1_Working Groups_Theory.doc	Supplementary Document	Uploaded 2011-10-06	Available
Cover Letter_2011_10-6-2011.doc	Supplementary Document	Uploaded 2011-10-06	Available
SSA_BRP_Generic_Theory_10-27-2011.doc	Supporting Statement A	Uploaded 2011-10-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212842	Self-affirmation and defensiveness to cancer risk information for the self vs. a close other	Form and Instruction	New	Self-Affirmation Survey Screenshots
212182	Goals and Values in Physical Activity Sub-Study #7	Form and Instruction	New	Focus Group Protocol
212182	Goals and Values in Physical Activity Sub-Study #7	Form and Instruction	New	Screener
212182	Goals and Values in Physical Activity Sub-Study #7	Form and Instruction	New	Survey
210991	Sub-study #8_Refining and validating a theory of risk perceptions	Form and Instruction	New	Screenshots
208373	Sub-study #6_Validating scale to assess cancer-related risk perceptions	Form and Instruction	New	Survey 3
208373	Sub-study #6_Validating scale to assess cancer-related risk perceptions	Form and Instruction	New	Survey 2
208373	Sub-study #6_Validating scale to assess cancer-related risk perceptions	Form and Instruction	New	Survey 1
208125	Sub-study #5_Patient Perspectives and Simulated Clinical Interactions	Form and Instruction	New	Simulated Clinical Interaction Survey
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Attachment B and D Screenshots
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Moderator Guide & Focus Group
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Eye Tracking Survey
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Moderators Guide and Interview
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Screener
207184	Sub-study #4_Alternative Tobacco Products Study	Form and Instruction	New	Baseline Survey
204704	Sub-Study #2_Informed Consent and Incidental Emotion	Form and Instruction	New	Questionnaire (Screenshots)
204704	Sub-Study #2_Informed Consent and Incidental Emotion	Form and Instruction	New	Screener
203967	Sub-study #3 Self-Affirmation REVISED	Form and Instruction	New	Self-Affirm Survey
201753	Sub-study #1_Self-Affirmation and Affect	Form and Instruction	New	Self-Affirmation Survey

ICR Details

OMB Control No: 0925-0645	ICR Reference No: 201111-0925-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: A Generic Submission for Theory Development and Validation (NCI)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/12/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/02/2011
Terms of Clearance: NCI will submit individual collections under this generic clearance to OMB that will include details that highlight the purpose, methodology, participants and burden of each project.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved
Responses	11,500	0	0
Time Burden (Hours)	6,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In order to carry out NCI's legislative mandate to conduct and support research with respect to the causes and prevention of cancer, it is beneficial for NCI, through initiatives in the Behavioral Research Program (BRP), to conduct and support behavioral research informed by and informing theory. Formative research in the area of theory development and validation would provide the basis for developing effective cancer prevention and control strategies, allow for a better understanding of theoretical constructs that influence decisions and actions related to cancer, and ultimately contribute to reducing the U.S. cancer burden. Data collections that result from this generic clearance would inform and clarify the use of theory in BRP-supported initiatives and funding announcements. Specifically, this research would allow NCI to conduct research to: 1) Identify psychological, biobehavioral, demographic, and individual difference predictors of cancer prevention and control behaviors and outcomes; 2) Develop and refine integrative theories; 3) Identify and observe theoretical and innovative trends in cancer prevention and control research; and 4) Determine feasibility and usefulness of collaborative and multidisciplinary approaches to cancer prevention and control. Respondents will be members of the public including, but not limited to, health professionals, physicians, and researchers.

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Authorizing Statute(s): US Code: 42 USC 285a-1 (412) Name of Law: Public Health Service Act
   US Code: 42 USC 285 (410) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 46307	08/02/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 62421	10/07/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Goals and Values in Physical Activity Sub-Study #7	1 , 2, 3	Screener ,   Survey ,   Focus Group Protocol
Self-affirmation and defensiveness to cancer risk information for the self vs. a close other	1	Self-Affirmation Survey Screenshots
Sub-Study #2_Informed Consent and Incidental Emotion	1, 2	Screener ,   Questionnaire (Screenshots)
Sub-study #1_Self-Affirmation and Affect	1	Self-Affirmation Survey
Sub-study #3 Self-Affirmation REVISED	1	Self-Affirm Survey
Sub-study #4_Alternative Tobacco Products Study	2, 1, 5, 3, 4, 2 and 3	Baseline Survey ,   Screener ,   Moderators Guide and Interview ,   Eye Tracking Survey ,   Moderator Guide & Focus Group ,   Attachment B and D Screenshots
Sub-study #5_Patient Perspectives and Simulated Clinical Interactions	1	Simulated Clinical Interaction Survey
Sub-study #6_Validating scale to assess cancer-related risk perceptions	1, 2, 3	Survey 1 ,   Survey 2 ,   Survey 3
Sub-study #8_Refining and validating a theory of risk perceptions	1	Screenshots

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ICR Summary of Burden

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	11,500	0	0	11,500	0	0
Annual Time Burden (Hours)	6,000	0	0	6,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new generic clearance request.

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Annual Cost to Federal Government: $352,979

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/02/2011

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