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Wave 3 Phase 1 Qualitative Research: General Market ("The Real Cost") At-Risk Youth Tobacco Prevention Focus Groups
Pretesting of Tobacco Communications
OMB: 0910-0674
IC ID: 215643
OMB.report
HHS/FDA
OMB 0910-0674
ICR 201406-0910-011
IC 215643
( )
Documents and Forms
Document Name
Document Type
General Market Youth Tobacco Wave 3 Assent Form 3 10 15.docx
Other-Assent Form
General Market Youth Tobacco Wave 3 Consent Form 3 10 15 doc.docx
Other-Consent Form
General Market Youth Tobacco Wave 3 Discussion Guide Updates for 3 10 15.doc
Other-Discussion Guide
General Market Youth Tobacco Wave 3 Screener 3 10 15.docx
Other-Screener
General Market Youth Tobacco Wave 3 Stimuli_02122015.docx
Other-Stimuli
General Market Youth Tobacco Wave 3 OMB Memo 3 10 15.docx
Supporting Statement Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Wave 3 Phase 1 Qualitative Research: General Market ("The Real Cost") At-Risk Youth Tobacco Prevention Focus Groups
Agency IC Tracking Number:
CTP
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Consent Form
General Market Youth Tobacco Wave 3 Consent Form 3 10 15 doc.docx
No
Printable Only
Other-Discussion Guide
General Market Youth Tobacco Wave 3 Discussion Guide Updates for 3 10 15.doc
No
Printable Only
Other-Screener
General Market Youth Tobacco Wave 3 Screener 3 10 15.docx
No
Printable Only
Other-Stimuli
General Market Youth Tobacco Wave 3 Stimuli_02122015.docx
No
Printable Only
Other-Assent Form
General Market Youth Tobacco Wave 3 Assent Form 3 10 15.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
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
540
0
0
0
Annual IC Time Burden (Hours)
363
0
363
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement Memo
General Market Youth Tobacco Wave 3 OMB Memo 3 10 15.docx
03/11/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.