Cognitive Testing for the PATH Study Wave 4 Questionnaires

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

OMB: 0925-0663

IC ID: 217825

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Cognitive Testing for the PATH Study Wave 4 Questionnaires
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction A-1 Recruitment Screener PATH Cognitive Testing Sub-study Attachment A-1. Adult Recruitment Screener 061915.docx Yes Yes Fillable Fileable
Form and Instruction A-2 Recruitment Screener PATH Cognitive Testing Sub-study Attachment A-2. ENDs Recruitment Screener 062215.docx Yes Yes Fillable Fileable
Form and Instruction A-3 Recruitment Screener PATH Cognitive Testing Sub-study Attachment A-3. Youth Recruitment Screener 061815.docx Yes Yes Fillable Fileable
Form and Instruction A-4 Recruitment Screener PATH Cognitive Testing Sub-study Attachment A-4. Young Adult Recruitment Screener 061915.docx Yes Yes Fillable Fileable
Form and Instruction B-1 Adult Interview Intro. PATH Cognitive Testing Sub-study Attachment B-1. Adult Interview Introduction 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-2 ENDS Interview Into. PATH Cognitive Testing Sub-study Attachment B-2. ENDS Interview Introduction 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-3 Youth Interview Intro PATH Cognitive Testing Sub-study Attachment B-3. Youth Interview Introduction 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-4 Screening Module PATH Cognitive Testing Sub-study Attachment B-4. Screening Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-5 Screening Module Images PATH Cognitive Testing Sub-study Attachment B-5. Screening Module Images 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-6 Adult Cigarettes Modlue PATH Cognitive Testing Sub-study Attachment B-6. Adult Cigarettes Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-7 Adult Hookah Module PATH Cognitive Testing Sub-study Attachment B-7. Adult Hookah Module 062215.docx Yes Yes Fillable Fileable
Form and Instruction B-8 Adult Smokeless/Snus Module PATH Cognitive Testing Sub-study Attachment B-8. Adult Smokeless Snus Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-9 Adult Harm Perceptions Module PATH Cognitive Testing Sub-study Attachment B-9. Adult Harm Perceptions Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-10 Adult Media Module PATH Cognitive Testing Sub-study Attachment B-10. Adult Media Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-11 Social Media Card Sort Imagines PATH Cognitive Testing Sub-study Attachment B-11. Social Media Card Sort Images 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-12 Adult Barcode Module PATH Cognitive Testing Sub-study Attachment B-12. Adult Barcode Scanning Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-13 Adult ENDS Module PATH Cognitive Testing Sub-study Attachment B-13. Adult ENDs Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-14 Young Adult Cigarettes Module PATH Cognitive Testing Sub-study Attachment B-14. Young Adult Cigarettes Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-15 Young Adult Hookah Module PATH Cognitive Testing Sub-study Attachment B-15. Young Adult Hookah Module 062215.docx Yes Yes Fillable Fileable
Form and Instruction B-16 Young Adult Demographics Module PATH Cognitive Testing Sub-study Attachment B-16. Young Adult Demographics Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-17 Youth Cigarettes Modulle PATH Cognitive Testing Sub-study Attachment B-17. Youth Cigarettes Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-18 Youth Hookah Module PATH Cognitive Testing Sub-study Attachment B-18. Youth Hookah Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-19 Youth Social Norms Module PATH Cognitive Testing Sub-study Attachment B-19. Youth Social Norms Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-20 Youth Harm Perceptions Module PATH Cognitive Testing Sub-study Attachment B-20. Youth Harm Perceptions Module 062115.docx Yes Yes Fillable Fileable
Form and Instruction B-21 Youth Media Module PATH Cognitive Testing Sub-study Attachment B-21. Youth Media Module 062115.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,071 0
   
Individuals or Households
 
   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 1,071 0 1,071 0 0 0
Annual IC Time Burden (Hours) 213 0 213 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Gen IC Justification Memo PATH Study Cognitive Testing Sub-study Memo 0925-0663 final rev 8-10-15.docx 08/10/2015
IRB Approval Letter PATH Cognitive Testing Sub-study Attachment C. IRB Approval Letter.pdf 08/10/2015
Consent Form PATH Cognitive Testing Sub-study Attachment D-1. Adult Consent Form 060415.docx 08/10/2015
Parental Permission and Youth Assent Forms PATH Cognitive Testing Sub-study Attachment D-2 Parental Permission and Youth Assent Form 071715.docx 08/10/2015
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