Cognitive Interviews to Support Development of Questionnaire Items for Wave 3

Generic Clearance for Cognitive Testing of Instrumentation and Materials for the PATH Study (NIDA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0663 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Cognitive Interviews to Support Development of Questionnaire Items for Wave 3 Form and Instruction
1 Recruitment Interview - English PATH OMB Attachment A English Interviews Recruitment Screener 072214.docx Form and Instruction
2 Spanish Interviews PATH OMB Attachment B Spanish Interviews Recruitment Screener 072214.docx Form and Instruction
3 Adult Consent PATH OMB Attachment C Adult Consent Form 072214.docx Form and Instruction
4 Youth Assent PATH OMB Attachment D Youth Parental Consent Youth Assent Form 072214.docx Form and Instruction
5 Study Protocol - Spanish PATH OMB Attachment E Spanish-Language Protocols 072214.docx Form and Instruction
6 Study Protocol - Spanish PATH OMB Attachment F English-Language Protocols 072214.docx Form and Instruction
PATH Study memo for OMB on reviews of Cognitive Testing Sub-Study for Wave 3 - 7-17-14.docx Special Memo PATH Study Memo IC Document
PATH Study Cognitive Testing Sub-Study Wave 3- GC 0925-0663 - 072214.docx Supporting Statement IC Document
PATH OMB Attachment G IRB Approval.docx IRB approval IC Document

Information Collection (IC) Details

IC Title:	Cognitive Interviews to Support Development of Questionnaire Items for Wave 3	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	1	Recruitment Interview - English	PATH OMB Attachment A English Interviews Recruitment Screener 072214.docx	No	Printable Only
Form and Instruction	2	Spanish Interviews	PATH OMB Attachment B Spanish Interviews Recruitment Screener 072214.docx	No	Printable Only
Form and Instruction	3	Adult Consent	PATH OMB Attachment C Adult Consent Form 072214.docx	No	Paper Only
Form and Instruction	4	Youth Assent	PATH OMB Attachment D Youth Parental Consent Youth Assent Form 072214.docx	No	Paper Only
Form and Instruction	5	Study Protocol - Spanish	PATH OMB Attachment E Spanish-Language Protocols 072214.docx	No	Printable Only
Form and Instruction	6	Study Protocol - Spanish	PATH OMB Attachment F English-Language Protocols 072214.docx	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 768	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	768	768
Annual IC Time Burden (Hours)	287	287
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Special Memo PATH Study Memo	PATH Study memo for OMB on reviews of Cognitive Testing Sub-Study for Wave 3 - 7-17-14.docx	07/18/2014
Supporting Statement	PATH Study Cognitive Testing Sub-Study Wave 3- GC 0925-0663 - 072214.docx	07/23/2014
IRB approval	PATH OMB Attachment G IRB Approval.docx	07/23/2014

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