Information Collection

Sub-study #3_Playing for Life: Reducing the Negative Impact of Tobacco on Youth and Young Adults through Video Games, Gaming, and Gamification

IC 208861 under ICR 201304-0925-003 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Sub-study #3_Playing for Life: Reducing the Negative Impact of Tobacco on Youth and Young Adults through Video Games, Gaming, and Gamification	Form and Instruction
1 Interview Guide Attachment B_Interview Guide_9-26-2013.docx	Form and Instruction
Gen IC Form.doc Gen IC Form	IC Document
Memo Tobacco Gaming IDIs_8-26-13.docx Memo Tobacco Gaming IDIs_8-26-13	IC Document
Attachment A_Invitation.doc Attachment A_Invitation	IC Document
Attachment C_AudioVideoRelease.docx Attachment C_AudioVideoRelease	IC Document
Attachment D_IRB&OHSRPReviews.pdf Attachment D_IRB&OHSRPReviews	IC Document

IC Title:

Sub-study #3_Playing for Life: Reducing the Negative Impact of Tobacco on Youth and Young Adults through Video Games, Gaming, and Gamification

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 and Instruction	1	Interview Guide	Attachment B_Interview Guide_9-26-2013.docx		No	No	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	20	0	0	0	0	0
Annual IC Time Burden (Hours)	10	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Gen IC Form	Gen IC Form.doc	08/26/2013
Memo Tobacco Gaming IDIs_8-26-13	Memo Tobacco Gaming IDIs_8-26-13.docx	08/26/2013
Attachment A_Invitation	Attachment A_Invitation.doc	08/26/2013
Attachment C_AudioVideoRelease	Attachment C_AudioVideoRelease.docx	08/26/2013
Attachment D_IRB&OHSRPReviews	Attachment D_IRB&OHSRPReviews.pdf	08/26/2013

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