Development of Messages for the Act Against AIDS National Testing Campaign

Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Development of Messages for the Act Against AIDS National Testing Campaign Form
Development of Messages Survey Att 2_Web-Based Survey.docx Form
Development of Messages Survey - screenshots Att 2a_New National Screen Shots.pdf Form
Screener Att 3_Web-Based Screener.docx Form
Supporting Statement A-Clean.docx Supporting Statement A IC Document
Supporting Statement B.docx Supporting Statement B IC Document
Att 4_Consent.docx Consent IC Document
Att 5_Email Reminder.docx Email Notification IC Document
Concepts.pdf Messages IC Document
Table shells_Web Survey_OMB_2015-2-24.docx Table Shells IC Document

Information Collection (IC) Details

IC Title:	Development of Messages for the Act Against AIDS National Testing Campaign	Agency IC Tracking Number:	15MG

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Development of Messages Survey	Att 2_Web-Based Survey.docx	Yes	Yes	Fillable Fileable
Form	none	Development of Messages Survey - screenshots	Att 2a_New National Screen Shots.pdf	Yes	Yes	Fillable Fileable
Form	none	Screener	Att 3_Web-Based Screener.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,744	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,744	3,744
Annual IC Time Burden (Hours)	871	871
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	Supporting Statement A-Clean.docx	06/17/2015
Supporting Statement B	Supporting Statement B.docx	06/17/2015
Consent	Att 4_Consent.docx	06/17/2015
Email Notification	Att 5_Email Reminder.docx	06/17/2015
Messages	Concepts.pdf	06/17/2015
Table Shells	Table shells_Web Survey_OMB_2015-2-24.docx	06/17/2015

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