Information Collection

GenIC Testing of Spanish-language Messages for the National Diabetes

IC 222786 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Appendix 1. Screener.docx Other-WORD
HMTS Supplement 063016.docx HMTS Supplement Document IC Document
HMTS Expedited Review Form-National DPP Spanish-language message testing 062416.pdf HMTS Expedited Review Request IC Document
Appendix 2. English-Spanish Messages.docx App 2_ English-Spanish Messages IC Document
Appendix 3 in-person consumer FGs 063016.pdf App 3_In-person Consumer FGs IC Document
Appendix 4 on-line consumer FGs 063016.pdf App 4_On-line Consure FGs IC Document
Appendix 5 family member in-person FGs 063016.pdf App 5_Family Member In-person FG IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	GenIC Testing of Spanish-language Messages for the National Diabetes	Agency IC Tracking Number:	16AWH

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
Other-WORD			Appendix 1. Screener.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 6 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	158	158
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HMTS Supplement Document	HMTS Supplement 063016.docx	08/02/2016
HMTS Expedited Review Request	HMTS Expedited Review Form-National DPP Spanish-language message testing 062416.pdf	08/02/2016
App 2_ English-Spanish Messages	Appendix 2. English-Spanish Messages.docx	08/02/2016
App 3_In-person Consumer FGs	Appendix 3 in-person consumer FGs 063016.pdf	08/02/2016
App 4_On-line Consure FGs	Appendix 4 on-line consumer FGs 063016.pdf	08/02/2016
App 5_Family Member In-person FG	Appendix 5 family member in-person FGs 063016.pdf	08/02/2016

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