Information Collection

Knowledge, Attitudes, and Practices about Dengue and Chikungunya among Travel Consultants and Aid Agencies

IC 218556 under ICR 201503-0920-002 · OMB 0920-0932.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0932 can be found here:

2018-04-10 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Knowledge, Attitudes, and Practices about Dengue and Chikungunya among Travel Consultants and Aid Agencies	Form and Instruction
Attachment I – Instructions for the Participation in Focus Group Discussions - English.docx	Instruction
Attachment I1 - Instructions for the Participation in Focus Group DiscussionsSpanish.docx	Instruction
Attachment H Script for Telephone Calls to Screen and Recruit Participants - English.docx	Instruction
Attachment H 1 - Script for Telephone Calls to Screen and Recruit Participants - Spanish.docx	Instruction
Moderator’s Guide of Questions for Focus Groups with Sen Attachment C - Moderator’s Guide of Questions for Focus Groups with Sending Agencies - English.docx	Form and Instruction
Moderator’s Guide of Questions for Focus Groups with Sen Attachment C.1 - Moderator’s Guide of Questions for Focus Groups with Sending Agencie - Spanish.docx	Form and Instruction
Moderator’s Guide for Focus Groups with Volunteers - Eng Attachment D – Moderator’s Guide for Focus Groups with Volunteers - English.docx	Form and Instruction
Moderator’s Guide for Focus Groups with Volunteers - Spa Attachment D.1 - Moderator’s Guide for Focus Groups with Volunteers - Spanish.docx	Form and Instruction
Attachment E – Verbal Consent for Participants of Focus Group regarding Travel Health Messages - English.docx Verbal Consent for Participants of Focus Group regarding Travel Health Messages - English	IC Document
Attachment E.1 - Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish.docx Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish	IC Document
Statement B - 0920-0932 Dengue and Chikungunya KAP_Travel Consultants and Aid Agencies.docx Supporting Statement B	IC Document
Statement A - 0920-0932 Dengue and Chikungunya KAP_Travel Consultants and Aid Agencies.docx Supporting Statement A	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Knowledge, Attitudes, and Practices about Dengue and Chikungunya among Travel Consultants and Aid Agencies

Agency IC Tracking Number:

15BFS

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	Moderatorâs Guide of Questions for Focus Groups with Sending Agencies - English	Attachment C - Moderatorâs Guide of Questions for Focus Groups with Sending Agencies - English.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Moderatorâs Guide of Questions for Focus Groups with Sending Agencies - Spanish	Attachment C.1 - Moderatorâs Guide of Questions for Focus Groups with Sending Agencie - Spanish.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Moderatorâs Guide for Focus Groups with Volunteers - English	Attachment D â Moderatorâs Guide for Focus Groups with Volunteers - English.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Moderatorâs Guide for Focus Groups with Volunteers - Spanish	Attachment D.1 - Moderatorâs Guide for Focus Groups with Volunteers - Spanish.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Attachment I â Instructions for the Participation in Focus Group Discussions - English.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Attachment I1 - Instructions for the Participation in Focus Group DiscussionsSpanish.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Attachment H Script for Telephone Calls to Screen and Recruit Participants - English.docx	NA	No		Fillable Fileable
Instruction			Attachment H 1 - Script for Telephone Calls to Screen and Recruit Participants - Spanish.docx	NA	Yes	Yes	Fillable Fileable

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: 360

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Verbal Consent for Participants of Focus Group regarding Travel Health Messages - English	Attachment E â Verbal Consent for Participants of Focus Group regarding Travel Health Messages - English.docx	10/13/2015
Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish	Attachment E.1 - Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish.docx	10/13/2015
Supporting Statement B	Statement B - 0920-0932 Dengue and Chikungunya KAP_Travel Consultants and Aid Agencies.docx	10/30/2015
Supporting Statement A	Statement A - 0920-0932 Dengue and Chikungunya KAP_Travel Consultants and Aid Agencies.docx	11/03/2015

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