Information Collection

Message testing among partners of pregnant women in Puerto Rico

IC 221594 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⚠️ Notice: This information collection may be referencing outdated material.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
Message testing among partners of pregnant women 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
Intercept Interviews with Public Audiences in Puerto Ric Entrevistas Centros Comerciales_final.docx	Form and Instruction
13.Flyer - Preventing mosquito bites.pdf Flyer - Preventing Mosquito Bites	IC Document
34.Flyer - Sexual Transmission for Partners of Pregnant Women.pdf Flyuer - Sexual Transmission for Partners of Pregnant Women	IC Document
30.Poster for hardware stores.pdf Poster for Hardware Store	IC Document
1a.Facebook.Four steps infographic.jpg Facebook - Four Steps Infographic	IC Document
2a.Facebook.Step 1 infographic.jpg Facebook - Step 1	IC Document
3a.Facebook.Step 2 infographic.jpg Facebook - Step 2	IC Document
4a.Facebook.Step 3 infographic.jpg Facebook - Step 3	IC Document
5a.Facebook.Step 4 infographic.jpg Facebook - Step 4	IC Document
1b.Twitter.Four steps infographic.jpg Twitter - Four Steps Infographic	IC Document
2b.Twitter.Step 1 infographic.jpg Twitter - Step 1	IC Document
3b.Twitter.Step 2 infographic.jpg Twitter - Step 2	IC Document
4b.Twitter.Step 3 infographic.jpg Twitter - Step 3	IC Document
5b.Twitter.Step 4 infographic.jpg Twitter - Step 4	IC Document
Transcript.Eng.PSAs.PRDH_4.2016.docx Zika PSA Transcript - English	IC Document
CAPSULAS ZIKA.Transcript.doc Zika PSA Transcript - Spanish	IC Document
IRB Non-research determination.pdf IRB Non-Research Determination	IC Document
HMTS - Message testing among partners of pregnant women in Puerto Rico - Expedited Review Form.pdf HMTS Expedited Review Request	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Message testing among partners of pregnant women in Puerto Rico

Agency IC Tracking Number:

16AMP

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 - English	Intercept interviews for testing messages with public audiences.docx	NA	No		Paper Only
Form and Instruction	NA	Intercept Interviews with Public Audiences in Puerto Rico to test Zika Prevention Messages - Spanish	Entrevistas Centros Comerciales_final.docx	NA	No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

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	60	60
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Flyer - Preventing Mosquito Bites	13.Flyer - Preventing mosquito bites.pdf	05/19/2016
Flyuer - Sexual Transmission for Partners of Pregnant Women	34.Flyer - Sexual Transmission for Partners of Pregnant Women.pdf	05/19/2016
Poster for Hardware Store	30.Poster for hardware stores.pdf	05/19/2016
Facebook - Four Steps Infographic	1a.Facebook.Four steps infographic.jpg	05/19/2016
Facebook - Step 1	2a.Facebook.Step 1 infographic.jpg	05/19/2016
Facebook - Step 2	3a.Facebook.Step 2 infographic.jpg	05/19/2016
Facebook - Step 3	4a.Facebook.Step 3 infographic.jpg	05/19/2016
Facebook - Step 4	5a.Facebook.Step 4 infographic.jpg	05/19/2016
Twitter - Four Steps Infographic	1b.Twitter.Four steps infographic.jpg	05/19/2016
Twitter - Step 1	2b.Twitter.Step 1 infographic.jpg	05/19/2016
Twitter - Step 2	3b.Twitter.Step 2 infographic.jpg	05/19/2016
Twitter - Step 3	4b.Twitter.Step 3 infographic.jpg	05/19/2016
Twitter - Step 4	5b.Twitter.Step 4 infographic.jpg	05/19/2016
Zika PSA Transcript - English	Transcript.Eng.PSAs.PRDH_4.2016.docx	05/19/2016
Zika PSA Transcript - Spanish	CAPSULAS ZIKA.Transcript.doc	05/19/2016
IRB Non-Research Determination	IRB Non-research determination.pdf	05/19/2016
HMTS Expedited Review Request	HMTS - Message testing among partners of pregnant women in Puerto Rico - Expedited Review Form.pdf	05/19/2016

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