Information Collection Request

Message Testing for Tobacco Communication Activities

ICR 201412-0920-008 · OMB 0920-0910 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Online Questionnaire Recruitment Screener / Questionnaire - Screenshots Form and Instruction New Available
Online Questionnaire Form and Instruction New Available
Online Questionnaire Recruitment Screener Form and Instruction New Available
Participant Feedback Questionnaire Form and Instruction New Available
Focus Group Moderator Guide - Dual User Form and Instruction New Available
Focus Group Moderator Guide - Exclusive Smokers Form and Instruction New Available
Pre-Focus Group Questionnaire and Informed Consent Form and Instruction New Available
Focus Group Screener Form and Instruction New Available
Online Questionnaire Form and Instruction New Available
Recruitment Screener for Online Questionnaire Form and Instruction New Available
Moderator's Guide Form New Available
Screener Form New Available
Survey Screenshots Form New Available
Screener Form New Available
Att 4b Example Main Questionnaire (2).doc Supplementary Document Uploaded 2014-12-17 Available
Att 4a. Example Screener.doc Supplementary Document Uploaded 2014-12-17 Available
Att 4. Example screener and questionnaire.pdf Supplementary Document Uploaded 2014-12-17 Available
684 Human Subjects Determination - RFTOP 2011-E-001.pdf Supplementary Document Uploaded 2014-12-16 Available
0920-0910 Att 5 Non-disclosure agreement.docx Supplementary Document Uploaded 2014-12-16 Available
Att 3. Overview of Data Collection Methods v3.0 06192014.docx Supplementary Document Uploaded 2014-12-16 Available
Att 2b. Summary of Public Comments.doc Supplementary Document Uploaded 2014-12-16 Available
Att 2a. Federal Register Notice.pdf Supplementary Document Uploaded 2014-12-16 Available
Att 1. Public Health Service Act.doc Supplementary Document Uploaded 2014-12-16 Available
0920-0910 SS Part A (2) docx Final.docx Supporting Statement A Uploaded 2014-12-16 Available
0920-0910_SS_Part B v6 10 31 2014.docx Supporting Statement B Uploaded 2014-12-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228614 National Tobacco Education Campaign Rough Cut Testing of Television Advertisements Form and Instruction NewOnline Questionnaire Recruitment Screener / Questionnaire - Screenshots
228614 National Tobacco Education Campaign Rough Cut Testing of Television Advertisements Form and Instruction NewOnline Questionnaire
228614 National Tobacco Education Campaign Rough Cut Testing of Television Advertisements Form and Instruction NewOnline Questionnaire Recruitment Screener
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewParticipant Feedback Questionnaire
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewFocus Group Moderator Guide - Dual User
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewFocus Group Moderator Guide - Exclusive Smokers
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewPre-Focus Group Questionnaire and Informed Consent
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewFocus Group Screener
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewOnline Questionnaire
226720 National Tobacco Education Campaign: Creative Concept Testing Form and Instruction NewRecruitment Screener for Online Questionnaire
222433 Message Platform Testing for Regular Cigarettes and Dual Use Other-Screenshots New
219063 Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems Form NewModerator's Guide
219063 Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems Form NewScreener
216586 Rough Cut Testing for the 2016 Tips Campaign Form NewSurvey Screenshots
216586 Rough Cut Testing for the 2016 Tips Campaign Form NewScreener

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved 03/31/2015
132,648 0 73,694
32,994 0 14,438
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Message Platform Testing for Regular Cigarettes and Dual Use
National Tobacco Education Campaign Rough Cut Testing of Television Advertisements NA, NA, NA ,   ,  
National Tobacco Education Campaign: Creative Concept Testing NA, NA, NA, NA, NA, NA, NA ,   ,   ,   ,   ,   ,  
Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems none, none ,  
Rough Cut Testing for the 2016 Tips Campaign none, none ,  

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 132,648 73,694 0 58,954 0 0
Annual Time Burden (Hours) 32,994 14,438 0 18,556 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No