Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0920 Attachment 2A_Web-based Screener_Spn	Form and Instruction	Unchanged	Available
Form 0920-0920 Attachment 1 Message Testing for the AAA Campaign - HispanicsLatinos	Form and Instruction	Unchanged	Available
Form 0920-0920 Attachment 2_Web-based Screener_Eng	Form and Instruction	Unchanged	Available
Form 0920-0920 Message Testing for the AAA Campaign - Hispanics/Latinos	Form and Instruction	Unchanged	Available
Survey	Form	Unchanged	Available
Screener	Form	Unchanged	Available
Att 3 - Screener	Form	Unchanged	Available
Att 2 - Survey Instrument	Form	Unchanged	Available
0920-0920 (14FJ) Revised SSB CHANGE REQUEST.docx	Supporting Statement B	Uploaded 2014-03-13	Available
0920-0920 (14FJ) Revised SSA CHANGE REQUES docxT.docx	Supporting Statement A	Uploaded 2014-03-13	Available
0920-0920 - MemoForChange Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2014-03-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
213907	Evaluating Social Marketing Campaigns Targeting Gay/Bisexual Men	Other-PDF	New
208872	Message Testing for the AAA Campaign - Hispanics/Latinos	Form and Instruction	Unchanged	Attachment 2A_Web-based Screener_Spn
208872	Message Testing for the AAA Campaign - Hispanics/Latinos	Form and Instruction	Unchanged	Attachment 1 Message Testing for the AAA Campaign - HispanicsLatinos
208872	Message Testing for the AAA Campaign - Hispanics/Latinos	Form and Instruction	Unchanged	Attachment 2_Web-based Screener_Eng
208872	Message Testing for the AAA Campaign - Hispanics/Latinos	Form and Instruction	Unchanged	Message Testing for the AAA Campaign - Hispanics/Latinos
207674	African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing	Form	Unchanged	Survey
207674	African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing	Form	Unchanged	Screener
206209	HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men	Form	Unchanged	Att 3 - Screener
206209	HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men	Form	Unchanged	Att 2 - Survey Instrument

ICR Details

OMB Control No: 0920-0920	ICR Reference No: 201403-0920-004
Status: Historical Active	Previous ICR Reference No: 201209-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 21568
Title: Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/14/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/13/2014
Terms of Clearance: Previous terms continue: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2015	02/28/2015	02/28/2015
Responses	72,000	0	72,000
Time Burden (Hours)	8,001	0	8,001
Cost Burden (Dollars)	0	0	0

---

Abstract: CDC requests to make a change in frequency of data collection from quarterly to varied.

---

Authorizing Statute(s): US Code: 42 USC 301.241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing	none, none	Screener ,   Survey
Evaluating Social Marketing Campaigns Targeting Gay/Bisexual Men
HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men	none, none	Att 2 - Survey Instrument ,   Att 3 - Screener
Message Testing for the AAA Campaign - Hispanics/Latinos	0920-0920, 0920-0920, 0920-0920, 0920-0920	Message Testing for the AAA Campaign - Hispanics/Latinos ,   Attachment 2_Web-based Screener_Eng ,   Attachment 1 Message Testing for the AAA Campaign - HispanicsLatinos ,   Attachment 2A_Web-based Screener_Spn

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	72,000	72,000	0	0	0	0
Annual Time Burden (Hours)	8,001	8,001	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $247,586

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/13/2014

---