Information Collection

Perform Formative Research to Test Messages Developed to Help Communicate 2015 Dietary Guidelines Recommendations

IC 218041 under ICR 201201-0584-026 · OMB 0584-0523.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0523 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A-1 Survey Invitation English 8 27 au.docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment A-1 Survey Invitati
Attachment A-2 Survey Invitation (Spanish)_aug21au.docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment A-2 Survey Invitati
Attachment B-1 Online Survey Screener (English)_aug21 PRAO recommendatio....docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment B-1 Online Survey S
Attachment B-2 Online Survey Screener (Spanish)_aug21au.docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment B-2 Online Survey S
Attachment C-1 Survey Instrument (English)_aug21 PRAO recommendation 8-2....docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment C-1 Survey Instrume
Attachment C-2 Survey Instrument (Spanish)_aug21au.docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment C-2 Survey Instrume
Attachment D-1 Consent Form (English)_aug20 PRAO recommendations 8-26-15 .docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment D-1 Consent Form (E
Attachment D-2 Consent Form (Spanish)_aug21AU.DOCX dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment D-2 Consent Form (S
ATTACHMENT D Privacy Act Statement.docx dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Other-Attachment D Privacy Act State
Attachment E 1 Confidentiality Agreement.docx Attachment E-1 Confidentiality Agreement (English)_aug21 PRAO recommendations 8-26-15 RG	IC Document
Copy of Copy of Burden hours quant.xlsx Burden Estimates Spreadsheet	IC Document
ATTACHMENT F-1 Privacy Act Statement.docx ATTACHMENT F-1 Privacy Act Statement	IC Document
CNPP OMB Cover Memo 0584-0523_Task 2_quant 8 19 PRAO recommendations 8-27-15 RGauclean.docx CNPP OMB Cover Memo 0584-0523_Task 2_quant 8 19 PRAO recommendations 8-27-15 RGauclean	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Perform Formative Research to Test Messages Developed to Help Communicate 2015 Dietary Guidelines Recommendations

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment A-2 Survey Invitation (Spanish)_aug21au	Attachment A-2 Survey Invitation (Spanish)_aug21au.docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment B-1 Online Survey Screener (English)_aug21 PRAO recommendatio...	Attachment B-1 Online Survey Screener (English)_aug21 PRAO recommendatio....docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment B-2 Online Survey Screener (Spanish)_aug21au	Attachment B-2 Online Survey Screener (Spanish)_aug21au.docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment C-1 Survey Instrument (English)_aug21 PRAO recommendation 8-2...	Attachment C-1 Survey Instrument (English)_aug21 PRAO recommendation 8-2....docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment C-2 Survey Instrument (Spanish)_aug21au	Attachment C-2 Survey Instrument (Spanish)_aug21au.docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment D-1 Consent Form (English)_aug20 PRAO recommendations 8-26-15	Attachment D-1 Consent Form (English)_aug20 PRAO recommendations 8-26-15 .docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment D-2 Consent Form (Spanish)_aug21AU	Attachment D-2 Consent Form (Spanish)_aug21AU.DOCX	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment A-1 Survey Invitation English 8 27 au	Attachment A-1 Survey Invitation English 8 27 au.docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable
Other-Attachment D Privacy Act Statement	ATTACHMENT D Privacy Act Statement.docx	http://dimensions.edgeresearch.com/e.asp?p=APT1501T&S=C	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports in the Federal Register on March 31, 2000,

FR Citation: 65 FR 17251

Number of Respondents: 1,577

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,362	5,362
Annual IC Time Burden (Hours)	492	492
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment E-1 Confidentiality Agreement (English)_aug21 PRAO recommendations 8-26-15 RG	Attachment E 1 Confidentiality Agreement.docx	08/28/2015
Burden Estimates Spreadsheet	Copy of Copy of Burden hours quant.xlsx	08/28/2015
ATTACHMENT F-1 Privacy Act Statement	ATTACHMENT F-1 Privacy Act Statement.docx	08/28/2015
CNPP OMB Cover Memo 0584-0523_Task 2_quant 8 19 PRAO recommendations 8-27-15 RGauclean	CNPP OMB Cover Memo 0584-0523_Task 2_quant 8 19 PRAO recommendations 8-27-15 RGauclean.docx	08/31/2015

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