American Indian/Alaska Native Campaign: Focus Group Study of Reactions to Strategic Concepts Designed to Prevent Youth Tobacco Use

Generic Clearance for the Collection of Qualitative Data on Tobacco Products and Communications

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Appendix A Youth FG info.docx Other-Youth Focus Group information
Appendix B 1 Youth Discussion Guide.docx Other-Youth Discussion Guide
Appendix B 2 Adult Disc Guide.docx Other-Adult Discussion Guide
Appendix C Informed_Consent_Form.docx Other-Informed Consent Form
Appendix D Youth Assent.docx Other-Youth Assent
Appendix E Adult FG info.docx Other-Adult Focus Group Information
Appendix G Adult Recruit Script Screener.docx Other-Adult Recruit Script Screener
Appendix H Youth Recruit Script Screener.docx Other-Youth Recruit Script Screener
AI-AN OMB Memo.docx AI-AN OMB Memo IC Document
Appendix F Sample Data Sharing Agreement.docx Sample Data Sharing Agreement IC Document

Information Collection (IC) Details

IC Title:	American Indian/Alaska Native Campaign: Focus Group Study of Reactions to Strategic Concepts Designed to Prevent Youth Tobacco Use	Agency IC Tracking Number:	CTP

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Adult Recruit Script Screener	Appendix G Adult Recruit Script Screener.docx	No	Paper Only
Other-Youth Recruit Script Screener	Appendix H Youth Recruit Script Screener.docx	No	Paper Only
Other-Youth Focus Group information	Appendix A Youth FG info.docx	No	Paper Only
Other-Youth Discussion Guide	Appendix B 1 Youth Discussion Guide.docx	No	Paper Only
Other-Adult Discussion Guide	Appendix B 2 Adult Disc Guide.docx	No	Paper Only
Other-Informed Consent Form	Appendix C Informed_Consent_Form.docx	No	Paper Only
Other-Youth Assent	Appendix D Youth Assent.docx	No	Paper Only
Other-Adult Focus Group Information	Appendix E Adult FG info.docx	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 580	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	580	580
Annual IC Time Burden (Hours)	508	508
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
AI-AN OMB Memo	AI-AN OMB Memo.docx	04/26/2016
Sample Data Sharing Agreement	Appendix F Sample Data Sharing Agreement.docx	04/26/2016

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