Development of a Motion Comic for HIV/STI Prevention Among Young People Ages 15-24 Phase 2

Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Document Name Document Type
Development of a Motion Comic for HIV/STI Prevention Among Young People Ages 15-24 Phase 2 Form
Motion Comic Pre Test Survey Att_1d_Participant Pre-Test Survey.docx Form
Motion Comic Focus Group Guide 2 Att_1c_Round 2 Focus Group Modertor Guide.docx Form
Motion Comic Screener Att_1a_Study Screener.docx Form
Motion Comic Post Test Survey Att_1e_Participant Post-Test Survey.docx Form
Motion Comic Focus Group Guide 1 Att_1b_Round 1 Focus Group Modertor Guide.docx Form
SS_Part B_ MotionComic 20MAR2013.docx Motion Comic Part B IC Document
Att_2b_Adolescent Parent Consent.docx Motion Comic Parent Consent IC Document
Att_2a_Adult Consent.docx Motion Comic Adult Consent IC Document
Att_2c_Adolescent Assent.docx Motion Comic Adolescent Assent IC Document
Att_4b_Recruitment Script.docx Motion Comic Recruitment Script IC Document
Att_3a_CDC IRB Approval.docx Motion Comic IRB Approval IC Document
Att_4a_Study Recruitment Flyer.docx Motion Comic Recruitment Flyer IC Document
SS_Part A_ Motion Comic 20MAR2013.docx Motion Comic Part A IC Document

Information Collection (IC) Details

IC Title:	Development of a Motion Comic for HIV/STI Prevention Among Young People Ages 15-24 Phase 2	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?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Motion Comic Pre Test Survey	Att_1d_Participant Pre-Test Survey.docx	Yes	Yes	Fillable Fileable
Form	none	Motion Comic Focus Group Guide 2	Att_1c_Round 2 Focus Group Modertor Guide.docx	Yes	No	Printable Only
Form	none	Motion Comic Screener	Att_1a_Study Screener.docx	Yes	Yes	Fillable Fileable
Form	none	Motion Comic Post Test Survey	Att_1e_Participant Post-Test Survey.docx	Yes	Yes	Fillable Fileable
Form	none	Motion Comic Focus Group Guide 1	Att_1b_Round 1 Focus Group Modertor Guide.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 540	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	540	0	0	0	0	0
Annual IC Time Burden (Hours)	275	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Motion Comic Part B	SS_Part B_ MotionComic 20MAR2013.docx	03/21/2013
Motion Comic Parent Consent	Att_2b_Adolescent Parent Consent.docx	03/21/2013
Motion Comic Adult Consent	Att_2a_Adult Consent.docx	03/21/2013
Motion Comic Adolescent Assent	Att_2c_Adolescent Assent.docx	03/21/2013
Motion Comic Recruitment Script	Att_4b_Recruitment Script.docx	03/21/2013
Motion Comic IRB Approval	Att_3a_CDC IRB Approval.docx	03/21/2013
Motion Comic Recruitment Flyer	Att_4a_Study Recruitment Flyer.docx	03/25/2013
Motion Comic Part A	SS_Part A_ Motion Comic 20MAR2013.docx	03/25/2013

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