Information Collection Request

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

ICR 201406-0925-001 · OMB 0925-0664 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 PATH/Baseline-Adults-Biospecimen: Blood Form and Instruction Unchanged Available
Form 1 PATH/Baseline-Adults-Biospecimen: Buccal Form and Instruction Modified Available
Form 1 PATH - Adults - Followup/Tracking Participant Information Form for Shadow Sample Youth(completed ny Parents)/Field Test Form and Instruction Unchanged Repair queued
Form 1 PATH/Baseline- Adults - Followup/Tracking Participant Information Form for Youth (completed by parents) Form and Instruction Unchanged Available
Form 1 PATH/Baseline- Adult-Parent Interview Form and Instruction Unchanged Available
Form 1 PATH/Baseline-Youth Extended Interview Form and Instruction Unchanged Available
Form 1 PATH/Baseline- Adults-Followup/Tracking Participant Information Form Form and Instruction Unchanged Repair queued
Form 1 PATH/Baseline- Adults -Tobacco Use Form Form and Instruction Unchanged Available
Form 1 PATH/Baseline-Adults-Biospecimen: Urine Form and Instruction Unchanged Available
Form 1 PATHBaseline- Adult Extended Interview Form and Instruction Unchanged Repair queued
Form 1 PATH/Baseline - Adults Individual Screener Form and Instruction Unchanged Available
Form 1 PATH/Baseline- Adults Household Screener Form and Instruction Unchanged Available
RS10 Adult Receipt_Urine Blood V1_04-14-14 REVISED.docx Supplementary Document Uploaded 2014-06-05 Available
CM4a Urine and Blood Collection Signature Form V1_04-14-14 REVISED.docx Supplementary Document Uploaded 2014-06-05 Available
CM4 Urine and Blood Collection Pamphlet V1_04-14-14 REVISED.docx Supplementary Document Uploaded 2014-06-05 Available
0925-0664 Change Request to Drop Buccal Cell Collection- PATH Study baseline 5-14.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-06-05 Available
FRT2 Adult Participant Information Form REVISED 121313.doc Supplementary Document Uploaded 2013-12-18 Available
FRT2 Adult Participant Information Form OMB-APPROVED 121313.doc Supplementary Document Uploaded 2013-12-18 Available
Non- sub change request memo - PATH Study 12-18-13.doc Justification for No Material/Nonsubstantive Change Uploaded 2013-12-18 Available
3d-Spanish. Biospecimen Collection Forms.pdf Supplementary Document Uploaded 2013-06-28 Available
3d-Spanish. Biospecimen Collection Forms.pdf Supplementary Document Uploaded 2013-06-28 Available
3j-Spanish. Followup Tracking Participant Information Form - Shadow Sample Youth.pdf Supplementary Document Uploaded 2013-06-28 Available
3i-Spanish. Followup Tracking Participant Information Form - Youth.pdf Supplementary Document Uploaded 2013-06-28 Available
3h. Spanish. PATH Wave 1 Parent Interview 7.5 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available
3g. Spanish. PATH Wave 1 Youth Extended Interview 7.5 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available
3e. Spanish. PATH Wave 1 Tobacco Use Form 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available
3d-Spanish. Biospecimen Collection Forms.pdf Supplementary Document Uploaded 2013-06-28 Available
3c. Spanish. PATH Wave 1 Adult Extended Interview 7.5 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available
3b. Spanish. PATH Wave 1 Individual Screener 7.5 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available
3a. Spanish. PATH Wave 1 Household Screener 7.5 2013-06-10.pdf Supplementary Document Uploaded 2013-06-28 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
207613 PATH/Baseline-Adults-Biospecimen: Blood Form and Instruction Unchanged
207612 PATH/Baseline-Adults-Biospecimen: Buccal Form and Instruction Modified
203772 PATH - Adults - Followup/Tracking Participant Information Form for Shadow Sample Youth(completed ny Parents)/Field Test Form and Instruction Unchanged
203763 PATH/Baseline- Adults - Followup/Tracking Participant Information Form for Youth (completed by parents) Form and Instruction Unchanged
203762 PATH/Baseline- Adult-Parent Interview Form and Instruction Unchanged
203761 PATH/Baseline-Youth Extended Interview Form and Instruction Unchanged
203760 PATH/Baseline- Adults-Followup/Tracking Participant Information Form Form and Instruction Unchanged
203759 PATH/Baseline- Adults -Tobacco Use Form Form and Instruction Unchanged
203758 PATH/Baseline-Adults-Biospecimen: Urine Form and Instruction Unchanged
203757 PATHBaseline- Adult Extended Interview Form and Instruction Unchanged
203756 PATH/Baseline - Adults Individual Screener Form and Instruction Unchanged
203755 PATH/Baseline- Adults Household Screener Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2015 11/30/2015 11/30/2015
546,222 0 560,451
132,620 0 136,889
0 0 0





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 546,222 560,451 0 -14,229 0 0
Annual Time Burden (Hours) 132,620 136,889 0 -4,269 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No