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Evaluation of Adapted Health Education Materials for LEP Spanish-Speakers and Indigenous Migrants
Data Collection for Evaluation of Education, Communication, and Training Activities
OMB: 0920-0932
IC ID: 206924
OMB.report
HHS/CDC
OMB 0920-0932
ICR 201203-0920-007
IC 206924
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0932 can be found here:
2018-04-10 - Revision of a currently approved collection
2015-04-09 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment C- Indigenous TB Discussion Guide.docx
Other-Focus Group Script
Attachment B-LEP TB QF Discussion Guide.docx
Other-Focus Group Script
Attachment D- LEP Flu Discussion Guide.docx
Other-Focus Group Script
Attachment E-Indigenous Flu Discussion Guide.docx
Other-Focus Group Script
Screener
Attachment F- Participant Screener.docx
Form
Attachment A-Materials for Adaptation.pdf
Materials for Adaptation
IC Document
Attachment G-IRB Determination.pdf
IRB Determination
IC Document
Attachment H-Participant Information Sheet.docx
Participant Information Sheet
IC Document
ECT Supporting Statement A.DOCX
Supporting Statement Part A
IC Document
ECT Supporting Statement B.DOCX
Supporting Statement Part B
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Evaluation of Adapted Health Education Materials for LEP Spanish-Speakers and Indigenous Migrants
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
Other-Focus Group Script
Attachment C- Indigenous TB Discussion Guide.docx
Yes
No
Fillable Printable
Other-Focus Group Script
Attachment B-LEP TB QF Discussion Guide.docx
Yes
No
Fillable Printable
Other-Focus Group Script
Attachment D- LEP Flu Discussion Guide.docx
Yes
No
Fillable Printable
Other-Focus Group Script
Attachment E-Indigenous Flu Discussion Guide.docx
Yes
No
Fillable Printable
Form
none
Screener
Attachment F- Participant Screener.docx
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
480
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
480
0
0
0
0
0
Annual IC Time Burden (Hours)
373
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Materials for Adaptation
Attachment A-Materials for Adaptation.pdf
05/14/2013
IRB Determination
Attachment G-IRB Determination.pdf
05/14/2013
Participant Information Sheet
Attachment H-Participant Information Sheet.docx
05/14/2013
Supporting Statement Part A
ECT Supporting Statement A.DOCX
05/15/2013
Supporting Statement Part B
ECT Supporting Statement B.DOCX
05/15/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.