Self-affirmation and defensiveness to cancer risk information for the self vs. a close other

A Generic Submission for Theory Development and Validation (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0645 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Self-affirmation and defensiveness to cancer risk information for the self vs. a close other Form and Instruction
1 Self-Affirmation Survey Screenshots Attachment A Survey Screenshots.doc Form and Instruction
Self Affirmation Justification Memo (3).docx Self Affrimation Justification Memo IC Document
Attachment B Selected Readings.doc Selected Reading IC Document
Attachment C IRB Approval.pdf IRB Approval IC Document
Attachment D Study Items Word Format 2014_0827.doc Survey- Word Version IC Document

Information Collection (IC) Details

IC Title:	Self-affirmation and defensiveness to cancer risk information for the self vs. a close other	Agency IC Tracking Number:

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 and Instruction	1	Self-Affirmation Survey Screenshots	Attachment A Survey Screenshots.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Self Affrimation Justification Memo	Self Affirmation Justification Memo (3).docx	08/27/2014
Selected Reading	Attachment B Selected Readings.doc	08/27/2014
IRB Approval	Attachment C IRB Approval.pdf	08/27/2014
Survey- Word Version	Attachment D Study Items Word Format 2014_0827.doc	08/27/2014

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