Multicultural Campaign: Wave 3 focus group study of reactions to creative advertising concepts designed to prevent multicultural 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⚠️ Notice: This information collection may be referencing outdated material.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
Check-In Survey.pdf Other-Check-In Survey
Creative Concept Stimuli.pdf Other-Creative Concept Stimuli
Creative Concept Survey.pdf Other-Creative Concept Survey
Moderator Guide.pdf Other-Moderator Guide
Parental Consent Verbal Script.pdf Other-Parental Consent Verbal Script
Parental Consent.pdf Other-Parental Consent
Parental Opt Out.pdf Other-Parental Opt Out
Participant Assent Form.pdf Other-Participant Assent Form
Screener.pdf Other-Screener
0910-0796 OMB Justification Memo.docx 0910-0796 OMB Justification Memo IC Document
Protocol Approval with Modification Notice and Approval Email Dec0216.pdf Protocol Approval with Modification Notice and Approval IC Document

Information Collection (IC) Details

IC Title:	Multicultural Campaign: Wave 3 focus group study of reactions to creative advertising concepts designed to prevent multicultural 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-Check-In Survey	Check-In Survey.pdf	No	Paper Only
Other-Creative Concept Stimuli	Creative Concept Stimuli.pdf	No	Printable Only
Other-Creative Concept Survey	Creative Concept Survey.pdf	No	Printable Only
Other-Moderator Guide	Moderator Guide.pdf	No	Printable Only
Other-Parental Consent Verbal Script	Parental Consent Verbal Script.pdf	No	Printable Only
Other-Parental Consent	Parental Consent.pdf	No	Paper Only
Other-Parental Opt Out	Parental Opt Out.pdf	No	Paper Only
Other-Participant Assent Form	Participant Assent Form.pdf	No	Paper Only
Other-Screener	Screener.pdf	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 720	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	720	720
Annual IC Time Burden (Hours)	345	345
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0910-0796 OMB Justification Memo	0910-0796 OMB Justification Memo.docx	12/13/2016
Protocol Approval with Modification Notice and Approval	Protocol Approval with Modification Notice and Approval Email Dec0216.pdf	12/13/2016

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