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Quantitative Study of Youth Reactions to Rough-Cut Advertising Designed to Prevent Smokeless Tobacco Use Among Rural Youth
Pretesting of Tobacco Communications
OMB: 0910-0674
IC ID: 217852
OMB.report
HHS/FDA
OMB 0910-0674
ICR 201406-0910-011
IC 217852
( )
Documents and Forms
Document Name
Document Type
Parent-Guardian Informed Consent_Rural Smokeless Copy.docx
Other-Informed Consent
Parent-Guardian Opt-Out_Rural Smokeless Copy.docx
Other-Opt-Out
Questionnaire_Rural Smokeless Copy.docx
Other-Questionnaire
Screener_Rural Smokeless Copy.docx
Other-Screener
SCRIPTS_.DOC
Other-Scripts
YOUTH-AS.DOC
Other-Youth Assent
OMB-MEMO.DOC
Supporting Statement Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Quantitative Study of Youth Reactions to Rough-Cut Advertising Designed to Prevent Smokeless Tobacco Use Among Rural Youth
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-Informed Consent
Parent-Guardian Informed Consent_Rural Smokeless Copy.docx
No
Printable Only
Other-Opt-Out
Parent-Guardian Opt-Out_Rural Smokeless Copy.docx
No
Printable Only
Other-Questionnaire
Questionnaire_Rural Smokeless Copy.docx
No
Printable Only
Other-Screener
Screener_Rural Smokeless Copy.docx
No
Printable Only
Other-Scripts
SCRIPTS_.DOC
No
Printable Only
Other-Youth Assent
YOUTH-AS.DOC
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:
2,394
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
2,394
0
2,394
0
0
0
Annual IC Time Burden (Hours)
865
0
865
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement Memo
OMB-MEMO.DOC
08/11/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.