Information Collection

Message Testing with Mothers for CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO)

IC 228558 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⚠️ Notice: This information collection may be referencing outdated material.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 with Mothers for CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO)	Form and Instruction
Screener and Survey for Online Participants (content is 4- APPENDIX B- Materials for online survey with mothers - DNPAO Message ....docx	Form and Instruction
Screener and Moderator's Guide for In-person Focus Group 5- APPENDIX C- Materials for focus groups with mothers - DNPAO Message T....docx	Form and Instruction
1 - HMTS Expedited Review Form - DNPAO Message Testing (10.17.17).pdf HMTS Template	IC Document
2 - HMTS Expedited Review Supplement - DNPAO Message Testing (10.17.17) CLEAN.docx Supplement to the HMTS Template - Narrative Project Description	IC Document
3- APPENDIX A- Messages to be Tested - DNPAO Message Testing (10.17.17) CLEAN.docx Messages to be Tested with Mothers	IC Document

IC Title:

Message Testing with Mothers for CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO)

Agency IC Tracking Number:

0920-17BCY

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	n/a	Screener and Survey for Online Participants (content is provided in screen shots and Word)	4- APPENDIX B- Materials for online survey with mothers - DNPAO Message ....docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Screener and Moderator's Guide for In-person Focus Group Participants	5- APPENDIX C- Materials for focus groups with mothers - DNPAO Message T....docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,160

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 93 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,160	2,160
Annual IC Time Burden (Hours)	767	767
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HMTS Template	1 - HMTS Expedited Review Form - DNPAO Message Testing (10.17.17).pdf	11/02/2017
Supplement to the HMTS Template - Narrative Project Description	2 - HMTS Expedited Review Supplement - DNPAO Message Testing (10.17.17) CLEAN.docx	11/02/2017
Messages to be Tested with Mothers	3- APPENDIX A- Messages to be Tested - DNPAO Message Testing (10.17.17) CLEAN.docx	11/02/2017

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