Information Collection

Focus Group Study of Youth Reactions to Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

IC 218581 under ICR 201411-0910-007 · OMB 0910-0796.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0796 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Addendum A - Instrument Pictures(Final).docx	Other-Instrument Pictures
Addendum B - Creative Concept Stimuli(Final).doc	Other-Creative Concept Stimuli
Addendum C - Photographs for Tobacco Discussion(Final).pptx	Other-Photographs for Tobacco Discus
Addendum D - Facts for Discussion(Final).docx	Other-Facts for Discussion
Check-In Survey (Final).pdf	Other-Check-In Survey
Creative Concept Survey(Final).docx	Other-Creative Concept Survey
Moderator Guide(Final).docx	Other-Moderator Guide
Parental Consent Form (RETAIN)(Final).doc	Other-Parental Consent Form (Retain)
Parental Consent Form (RETURN)(Final).doc	Other-Parental Consent Form (Return)
Parental Opt-Out(Final).doc	Other-Parental Opt-Out
Participant Assent Form (RETAIN)(Final).doc	Other-Participant Assent Form (Retai
Participant Assent Form (RETURN)(Final).doc	Other-Participant Assent Form (Retur
Screener Script(Final).docx	Other-Screener Script
Screener(Final).pdf	Other-Screener
OMB Justification Memo.docx Supporting Statement Memo	IC Document

IC Title:

Focus Group Study of Youth Reactions to Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

Agency IC Tracking Number:

CTP

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Instrument Pictures	Addendum A - Instrument Pictures(Final).docx	No	Printable Only
Other-Creative Concept Stimuli	Addendum B - Creative Concept Stimuli(Final).doc	No	Printable Only
Other-Photographs for Tobacco Discussion	Addendum C - Photographs for Tobacco Discussion(Final).pptx	No	Printable Only
Other-Facts for Discussion	Addendum D - Facts for Discussion(Final).docx	No	Printable Only
Other-Check-In Survey	Check-In Survey (Final).pdf	No	Printable Only
Other-Creative Concept Survey	Creative Concept Survey(Final).docx	No	Printable Only
Other-Moderator Guide	Moderator Guide(Final).docx	No	Printable Only
Other-Parental Consent Form (Retain)	Parental Consent Form (RETAIN)(Final).doc	No	Printable Only
Other-Parental Consent Form (Return)	Parental Consent Form (RETURN)(Final).doc	No	Printable Only
Other-Parental Opt-Out	Parental Opt-Out(Final).doc	No	Printable Only
Other-Participant Assent Form (Retain)	Participant Assent Form (RETAIN)(Final).doc	No	Printable Only
Other-Participant Assent Form (Return)	Participant Assent Form (RETURN)(Final).doc	No	Printable Only
Other-Screener Script	Screener Script(Final).docx	No	Printable Only
Other-Screener	Screener(Final).pdf	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,800

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 Agency Discretion
Annual Number of Responses for this IC	1,800	1,800
Annual IC Time Burden (Hours)	870	870
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Memo	OMB Justification Memo.docx	10/15/2015

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