Information Collection

Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems

IC 219063 under ICR 201412-0920-008 · OMB 0920-0910.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

Documents and Forms

Document Name Document Type
Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems Form
Screener Att 1-Screener 11 23 15.doc Form
Moderator's Guide Att 4-Moderator's Guide 11 20 15.docx Form
0920-0910_Part A_OSH ENDS Focus Groups 11 20 15.docx SS Part A IC Document
0920-0910_Part B_OSH ENDS Focus Groups 11 20 15.docx SS Part B IC Document
Att 2-Informed Consent doc 11 20 15.doc Informed Consent IC Document
Att 3 ICF Institutional Review Board Approval.pdf IRB IC Document
Attachment 5 ENDS and 2014 SGR Fact Sheet OSH ENDS Focus Groups_lje.pdf Fact Sheet IC Document
Att 6-Confirmation Script docx 11 20 15.docx Confirmation Script IC Document
Att 7- Smoker Cessation Material Fact Sheet.pdf Material Fact Sheet IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems	Agency IC Tracking Number:	16FS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Screener	Att 1-Screener 11 23 15.doc		No		Paper Only
Form	none	Moderator's Guide	Att 4-Moderator's Guide 11 20 15.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 270	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	270	270
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SS Part A	0920-0910_Part A_OSH ENDS Focus Groups 11 20 15.docx	11/24/2015
SS Part B	0920-0910_Part B_OSH ENDS Focus Groups 11 20 15.docx	11/24/2015
Informed Consent	Att 2-Informed Consent doc 11 20 15.doc	11/24/2015
IRB	Att 3 ICF Institutional Review Board Approval.pdf	11/24/2015
Fact Sheet	Attachment 5 ENDS and 2014 SGR Fact Sheet OSH ENDS Focus Groups_lje.pdf	11/24/2015
Confirmation Script	Att 6-Confirmation Script docx 11 20 15.docx	11/24/2015
Material Fact Sheet	Att 7- Smoker Cessation Material Fact Sheet.pdf	11/24/2015

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