Information Collection

HMTS - Message testing among important public audiences in Puerto Rico

IC 221272 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HMTS - Message testing among important public audiences in Puerto Rico	Form and Instruction
Intercept Interviews with Public Audiences in Puerto Ric Intercept interviews for testing messages with public audiences.docx	Form and Instruction
1a.Facebook.Four steps infographic.jpg Facebook Four Steps - Infographic	IC Document
1b.Twitter.Four steps infographic.jpg Twitter Four Steps - Infographic	IC Document
2a.Facebook.Step 1 infographic.jpg Facebook Step 1 - Infographic	IC Document
2b.Twitter.Step 1 infographic.jpg Twitter Step 1 - Infographic	IC Document
3a.Facebook.Step 2 infographic.jpg Facebook Step 2 - Infographic	IC Document
3b.Twitter.Step 2 infographic.jpg Twitter Step 2 - Infographic	IC Document
4a.Facebook.Step 3 infographic.jpg Facebook Step 3 - Infographic	IC Document
4b.Twitter.Step 3 infographic.jpg Twitter Step 3 - Infographic	IC Document
5a.Facebook.Step 4 infographic.jpg Facebook Step 4 - Infographic	IC Document
5b.Twitter.Step 4 infographic.jpg Twitter Step 4 - Infographic	IC Document
13.Flyer - Preventing mosquito bites.pdf Flyer - Preventing Mosquito Bites	IC Document
25.Zika Billboard 5c-01.jpg Zika Billboard - 5c-01	IC Document
26.Zika Billboard 3c-01.jpg Zika Billboard 3c-01	IC Document
27.Zika Billboard 4c-01.jpg Zika Billboard 4c-01	IC Document
28.Tri-fold community members - Protect against Zika.pdf Tri-fold Community Members - Protect Against Zika	IC Document
29.Tri-fold for Pregnant women.-Protect against Zika.pdf Tri-fold Pregnant Women - Protect Against Zika	IC Document
30.Poster for hardware stores.pdf Poster - Hardware Stores	IC Document
31.Poster for pharmacies and community.pdf Poster - Pharmacy and Community	IC Document
32.Flyer - Pregnant and living in an area with Zika.pdf Flyer - Pregnant Women Living in an area with Zika	IC Document
33.Flyer - Sexual Transmission for Pregnant Women.pdf Flyer - Sexual Transmission for Pregnant Women	IC Document
34.Flyer - Sexual Transmission for Partners of Pregnant Women.pdf Flyer - Sexual Transmission for Partners of Pregnant Women	IC Document
35a.Health advisory for Puerto Rico - talk to doctor.English.pdf Health Advisory Puerto Rico - Talk to Doctor English	IC Document
35b.Health adviosry for Puerto Rico - talk to doctor.Spanish.pdf Health Advisory Puerto Rico - Talk to Doctor Spanish	IC Document
36a.Health advisory for Puerto Rico - mosquito bite prevention.English.pdf Health Advisory Puerto Rico - Mosquito Bite Prevention English	IC Document
36b.Health advisory for Puerto Rico - mosquito bite prevention.Spanish.pdf Health Advisory Puerto Rico - Mosquito Bite Prevention Spanish	IC Document
37a.Health advisory in areas with Zika - mosquito bite prevention.English.pdf Health Advisory in areas with Zika - Mosquito Bite Prevention English	IC Document
37b.Health advisory in areas with Zika - mosquito bite prevention.Spanish.pdf Health Advisory in areas with Zika - Mosquito Bite Prevention Spanish	IC Document
38.Mosquito Bite Prevention for Travelers.English.pdf Mosquito Bite Prevention for Travelers	IC Document
39.Zika prevention - spring break for college students.English.pdf Zika Prevention - Spring Break for College Students English	IC Document
40.Zika prevention - spring break for families.English.pdf Zika Prevention - Spring Break for Families English	IC Document
IRB Non-research determination.pdf IRB Non-Research Determination	IC Document
CAPSULAS ZIKA.Transcript.doc Public Service Announcement - PRDH Transcript Spanish	IC Document
Transcript.Eng.PSAs.PRDH_4.2016.docx Public Service Announcement - PRDH Transcript English	IC Document
HMTS --Puerto Rico Zika PSA - Expedited Review Form.pdf HMTS Expedited Review Form	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

HMTS - Message testing among important public audiences in Puerto Rico

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Intercept Interviews with Public Audiences in Puerto Rico to test Zika Prevention Messages	Intercept interviews for testing messages with public audiences.docx	NA	No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Facebook Four Steps - Infographic	1a.Facebook.Four steps infographic.jpg	04/29/2016
Twitter Four Steps - Infographic	1b.Twitter.Four steps infographic.jpg	04/29/2016
Facebook Step 1 - Infographic	2a.Facebook.Step 1 infographic.jpg	04/29/2016
Twitter Step 1 - Infographic	2b.Twitter.Step 1 infographic.jpg	04/29/2016
Facebook Step 2 - Infographic	3a.Facebook.Step 2 infographic.jpg	04/29/2016
Twitter Step 2 - Infographic	3b.Twitter.Step 2 infographic.jpg	04/29/2016
Facebook Step 3 - Infographic	4a.Facebook.Step 3 infographic.jpg	04/29/2016
Twitter Step 3 - Infographic	4b.Twitter.Step 3 infographic.jpg	04/29/2016
Facebook Step 4 - Infographic	5a.Facebook.Step 4 infographic.jpg	04/29/2016
Twitter Step 4 - Infographic	5b.Twitter.Step 4 infographic.jpg	04/29/2016
Flyer - Preventing Mosquito Bites	13.Flyer - Preventing mosquito bites.pdf	04/29/2016
Zika Billboard - 5c-01	25.Zika Billboard 5c-01.jpg	04/29/2016
Zika Billboard 3c-01	26.Zika Billboard 3c-01.jpg	04/29/2016
Zika Billboard 4c-01	27.Zika Billboard 4c-01.jpg	04/29/2016
Tri-fold Community Members - Protect Against Zika	28.Tri-fold community members - Protect against Zika.pdf	04/29/2016
Tri-fold Pregnant Women - Protect Against Zika	29.Tri-fold for Pregnant women.-Protect against Zika.pdf	04/29/2016
Poster - Hardware Stores	30.Poster for hardware stores.pdf	04/29/2016
Poster - Pharmacy and Community	31.Poster for pharmacies and community.pdf	04/29/2016
Flyer - Pregnant Women Living in an area with Zika	32.Flyer - Pregnant and living in an area with Zika.pdf	04/29/2016
Flyer - Sexual Transmission for Pregnant Women	33.Flyer - Sexual Transmission for Pregnant Women.pdf	04/29/2016
Flyer - Sexual Transmission for Partners of Pregnant Women	34.Flyer - Sexual Transmission for Partners of Pregnant Women.pdf	04/29/2016
Health Advisory Puerto Rico - Talk to Doctor English	35a.Health advisory for Puerto Rico - talk to doctor.English.pdf	04/29/2016
Health Advisory Puerto Rico - Talk to Doctor Spanish	35b.Health adviosry for Puerto Rico - talk to doctor.Spanish.pdf	04/29/2016
Health Advisory Puerto Rico - Mosquito Bite Prevention English	36a.Health advisory for Puerto Rico - mosquito bite prevention.English.pdf	04/29/2016
Health Advisory Puerto Rico - Mosquito Bite Prevention Spanish	36b.Health advisory for Puerto Rico - mosquito bite prevention.Spanish.pdf	04/29/2016
Health Advisory in areas with Zika - Mosquito Bite Prevention English	37a.Health advisory in areas with Zika - mosquito bite prevention.English.pdf	04/29/2016
Health Advisory in areas with Zika - Mosquito Bite Prevention Spanish	37b.Health advisory in areas with Zika - mosquito bite prevention.Spanish.pdf	04/29/2016
Mosquito Bite Prevention for Travelers	38.Mosquito Bite Prevention for Travelers.English.pdf	04/29/2016
Zika Prevention - Spring Break for College Students English	39.Zika prevention - spring break for college students.English.pdf	04/29/2016
Zika Prevention - Spring Break for Families English	40.Zika prevention - spring break for families.English.pdf	04/29/2016
IRB Non-Research Determination	IRB Non-research determination.pdf	04/29/2016
Public Service Announcement - PRDH Transcript Spanish	CAPSULAS ZIKA.Transcript.doc	04/29/2016
Public Service Announcement - PRDH Transcript English	Transcript.Eng.PSAs.PRDH_4.2016.docx	04/29/2016
HMTS Expedited Review Form	HMTS --Puerto Rico Zika PSA - Expedited Review Form.pdf	05/02/2016

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