HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men

Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men Form
Att 2 - Survey Instrument Attachment 2_Web-based Survey Instrument.pdf Form
Att 3 - Screener Attachment 3_Web-based Survey Screener.pdf Form
Supporting Statement A_clean.docx Supporting Statement A IC Document
Supporting Statement B.docx Supporting Statement B IC Document
Response to Julie Wise Comments_02-11-13.docx Response to OMB IC Document
Attachment 4_Web-based Survey Consent.pdf Att 4 - Consent IC Document
Attachment 5_Web-based Survey Reminder Emails.pdf Att 5- Reminder Emails IC Document
MSM AR Taglines and Messages for Testing R3.pdf Messages IC Document
MSM Creative Concepts.pdf Creative Concepts IC Document

Information Collection (IC) Details

IC Title:	HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men	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	none	Att 2 - Survey Instrument	Attachment 2_Web-based Survey Instrument.pdf		Yes	Yes	Fillable Fileable
Form	none	Att 3 - Screener	Attachment 3_Web-based Survey Screener.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,283	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	1,283	0	0	0	0	0
Annual IC Time Burden (Hours)	299	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	Supporting Statement A_clean.docx	03/20/2013
Supporting Statement B	Supporting Statement B.docx	03/20/2013
Response to OMB	Response to Julie Wise Comments_02-11-13.docx	03/20/2013
Att 4 - Consent	Attachment 4_Web-based Survey Consent.pdf	03/20/2013
Att 5- Reminder Emails	Attachment 5_Web-based Survey Reminder Emails.pdf	03/20/2013
Messages	MSM AR Taglines and Messages for Testing R3.pdf	03/20/2013
Creative Concepts	MSM Creative Concepts.pdf	03/20/2013

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