Information Collection

African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing

IC 207674 under ICR 201209-0920-006 · OMB 0920-0920.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing	Form
Screener Att 3_ Screener.pdf	Form
Survey Att 2_Survey_07-03-2013.pdf	Form
Att 4_ Consent Form.pdf Consent	IC Document
Att 5_Survey Reminder E-Mails.docx Survey Emails	IC Document
Att 6_TCTT Creative_REV 07-03-2013.pdf Campaign Materials	IC Document
SSB.docx Supporting Statement B	IC Document
SSA_CLEAN_07-03-2013.docx Supporting Statement A	IC Document

IC Title:

African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Screener	Att 3_ Screener.pdf		Yes	Yes	Fillable Fileable
Form	none	Survey	Att 2_Survey_07-03-2013.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 466

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	466	466
Annual IC Time Burden (Hours)	109	109
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Consent	Att 4_ Consent Form.pdf	07/03/2013
Survey Emails	Att 5_Survey Reminder E-Mails.docx	07/03/2013
Campaign Materials	Att 6_TCTT Creative_REV 07-03-2013.pdf	07/08/2013
Supporting Statement B	SSB.docx	07/03/2013
Supporting Statement A	SSA_CLEAN_07-03-2013.docx	07/08/2013

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