Information Collection Request

HIV Prevention among Latino MSM: Evaluation of a locally developed intervention

ICR 201411-0920-007 · OMB 0920-0942 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Attachment 5a - 6 month follow-up assessment Spanish.docx Supplementary Document Uploaded 2014-11-21 Repair queued
Attachment 2a - Public Comment.docx Supplementary Document Uploaded 2014-11-21 Available
Attachment 2 - 60 Day FRN.pdf Supplementary Document Uploaded 2014-11-21 Available
SupSta B_111814 tfs4.docx Supporting Statement B Uploaded 2014-11-21 Available
Attachments 6a-6b - Two Versions of Study Ads.docx Supplementary Document Uploaded 2012-06-12 Available
Attachment 11 - CAB membership list.docx Supplementary Document Uploaded 2012-02-08 Available
Attachment 10 - All-PI meeting participant list.docx Supplementary Document Uploaded 2012-02-08 Repair queued
Attachment 9 - NCHHSTP project determination.pdf Supplementary Document Uploaded 2012-02-08 Available
Attachment 8 - Local IRB approvals.pdf Supplementary Document Uploaded 2012-02-08 Available
Attachment 1 - Public Health Service Act.docx Supplementary Document Uploaded 2012-02-08 Available
Attachment 7 - Consent forms.pdf Supplementary Document Uploaded 2012-02-08 Available
SupSta A_111814_tfs4.docx Supporting Statement A Uploaded 2014-11-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
201268 6-Month Follow-up Assessment Other-Attachment 5 - Six-Month Follow-Up Assessment Unchanged
201267 Baseline Assessment Questionnaire Other-Attachment 4 Baseline Assessment questionnaire Unchanged
201266 Participant Screening Form Other-Attachment 3 Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2018 06/30/2016 06/30/2015
950 0 950
883 0 883
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Participant Screening Form
Baseline Assessment Questionnaire
6-Month Follow-up Assessment

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 950 950 0 0 0 0
Annual Time Burden (Hours) 883 883 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No