Information Collection

Domestic Readiness Initiative on Zika Virus Disease: Year 2 Message & Materials Testing

IC 227732 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⚠️ Notice: This information collection may be referencing outdated material.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
Domestic Readiness Initiative on Zika Virus Disease: Year 2 Message & Materials Testing	Form and Instruction
Community Leader - Focus Group Screening Instrument Att2_CommLeadr_Screener_FG__final.docx	Form and Instruction
Men/Women Reproductive Age (18-49) - Focus Group Screeni Att3_Men_Women Screener_FG_finaL.docx	Form and Instruction
Community Leader - Focus Group Guide Att4_CommLeadr Focus Group Guide_final.docx	Form and Instruction
Men/Women Reproductive Age (18-49) - Focus Group Guide Att5_Men_Women Focus Group Guide_final.docx	Form and Instruction
Att6A_How to Protect Against Mosquito Bites.pdf How to Protect Against Mosquito Bites - English	IC Document
Att6B_How to Protect Against Mosquito Bites_SPANISH.pdf How to Protect Against Mosquito Bites - Spanish	IC Document
Att6C_Mosquito Control Promote the Partnership in Your Community.pdf Mosquito Control - Promote the Partnership in Your Community - English	IC Document
Att6D_Mosquito Control Promote the Partnership in Your Community_SPANISH.PDF Mosquito Control - Promote the Partnership in Your Community - Spanish	IC Document
Att6E_Protect Your Family and Community- How Zika Spreads.pdf Protect Your Family and Community- How Zika Spreads - English	IC Document
Att6F_Protect Your Family and Community- How Zika Spreads_SPANISH.pdf Protect Your Family and Community- How Zika Spreads - Spanish	IC Document
Att7A_ Protect Your Family and Community- How Zika Spreads.pdf Protect Your Family and Community- How Zika Spreads - English	IC Document
Att7B_Protect Your Family and Community- How Zika Spreads_SPANISH.pdf Protect Your Family and Community- How Zika Sprea - Spanish	IC Document
Att7C_Why We Are All Responsible- No Text.pdf Why We Are All Responsible for Zika Prevention - No Text English	IC Document
Att7D_Why We Are All Responsible for Zika Prevention-No Text SPANISH.pdf Why We Are All Responsible for Zika Prevention - No Text Spanish	IC Document
Att7E_Why We Are All Responsible for Zika Prevention-With Text.pdf Why We Are All Responsible for Zika Prevention - With Text English	IC Document
Att7F_Why We Are All Responsible for Zika Prevention-With Text_SPANISH.pdf Why We Are All Responsible for Zika Prevention - With Text Spanish	IC Document
Att7G_Picking and Using an Insect Repellent.pdf Picking and Using an Insect Repellent - English	IC Document
Att7H_Picking and Using an Insect Repellent_SPANISH.pdf Picking and Using an Insect Repellent - Spanish	IC Document
Att8_OADC Research_non-research Determination_task10_Zika(f).docx Non-Research Determination	IC Document
Att9_List of attachments_final.docx List of Attachments	IC Document
HMTSExpeditedReviewForm_T10-final.pdf 0920-0572 - HMTS Request	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Domestic Readiness Initiative on Zika Virus Disease: Year 2 Message & Materials Testing

Agency IC Tracking Number:

0920-0572-17AUY

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?	Electronic Capability
Form and Instruction	NA	Community Leader - Focus Group Screening Instrument	Att2_CommLeadr_Screener_FG__final.docx	NA	No	Paper Only
Form and Instruction	NA	Men/Women Reproductive Age (18-49) - Focus Group Screening Instrument	Att3_Men_Women Screener_FG_finaL.docx	NA	No	Paper Only
Form and Instruction	NA	Community Leader - Focus Group Guide	Att4_CommLeadr Focus Group Guide_final.docx	NA	No	Paper Only
Form and Instruction	NA	Men/Women Reproductive Age (18-49) - Focus Group Guide	Att5_Men_Women Focus Group Guide_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: 125

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	125	125
Annual IC Time Burden (Hours)	73	73
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
How to Protect Against Mosquito Bites - English	Att6A_How to Protect Against Mosquito Bites.pdf	07/27/2017
How to Protect Against Mosquito Bites - Spanish	Att6B_How to Protect Against Mosquito Bites_SPANISH.pdf	07/27/2017
Mosquito Control - Promote the Partnership in Your Community - English	Att6C_Mosquito Control Promote the Partnership in Your Community.pdf	07/27/2017
Mosquito Control - Promote the Partnership in Your Community - Spanish	Att6D_Mosquito Control Promote the Partnership in Your Community_SPANISH.PDF	07/27/2017
Protect Your Family and Community- How Zika Spreads - English	Att6E_Protect Your Family and Community- How Zika Spreads.pdf	07/27/2017
Protect Your Family and Community- How Zika Spreads - Spanish	Att6F_Protect Your Family and Community- How Zika Spreads_SPANISH.pdf	07/27/2017
Protect Your Family and Community- How Zika Spreads - English	Att7A_ Protect Your Family and Community- How Zika Spreads.pdf	07/27/2017
Protect Your Family and Community- How Zika Sprea - Spanish	Att7B_Protect Your Family and Community- How Zika Spreads_SPANISH.pdf	07/27/2017
Why We Are All Responsible for Zika Prevention - No Text English	Att7C_Why We Are All Responsible- No Text.pdf	07/27/2017
Why We Are All Responsible for Zika Prevention - No Text Spanish	Att7D_Why We Are All Responsible for Zika Prevention-No Text SPANISH.pdf	07/27/2017
Why We Are All Responsible for Zika Prevention - With Text English	Att7E_Why We Are All Responsible for Zika Prevention-With Text.pdf	07/27/2017
Why We Are All Responsible for Zika Prevention - With Text Spanish	Att7F_Why We Are All Responsible for Zika Prevention-With Text_SPANISH.pdf	07/27/2017
Picking and Using an Insect Repellent - English	Att7G_Picking and Using an Insect Repellent.pdf	07/27/2017
Picking and Using an Insect Repellent - Spanish	Att7H_Picking and Using an Insect Repellent_SPANISH.pdf	07/27/2017
Non-Research Determination	Att8_OADC Research_non-research Determination_task10_Zika(f).docx	07/27/2017
List of Attachments	Att9_List of attachments_final.docx	07/27/2017
0920-0572 - HMTS Request	HMTSExpeditedReviewForm_T10-final.pdf	07/27/2017

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