Information Collection

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

IC 226980 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment D Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteer	Instruction
Attachment D1 Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Voluntee	Instruction
Attachment D Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteer	Instruction
Attachment D1 Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Voluntee	Instruction
Moderator’s Guide of Questions for Focus Groups with Sen Attachment A - Moderator's Guide of Questions for Focus Group with Sending Agencies - English.docx	Form and Instruction
Moderator’s Guide of Questions for Focus Groups with Sen Attachment A1 - Moderator's Guide of Questions for Focus Group with Sending Agencies - Spanish.docx	Form and Instruction
Moderator’s Guide of Questions for Focus Groups with Mis Attachment B - Moderator’s Guide for Focus Groups with Missionaries_Volunteers - English.docx	Form and Instruction
Moderator’s Guide of Questions for Focus Groups with Mis Attachment B1 - Moderator's Guide for Missionaries_Volunteers - Spanish.docx	Form and Instruction
Attachment C - Verbal Consent for Participants for Focus Group regarding Travel Health Messages - English.docx Verbal Consent for Participants of Focus Group regarding Travel Health Messages - English	IC Document
Attachment C1 - Verbal Consent for Participants for Focus Group regarding Travel Health Messages - Spanish.docx Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish	IC Document
Attachment E - Protocol 6009 Knowledge Attitudes and Practices about Travel Health among Aid Agency Staff and Volunteers.docx Project Description	IC Document
Attachment F - Exemption Determination Letter.docx Research Determination - Exemtion of Amendment	IC Document
Attachment G - Instructions for the Participation in Focus Group Discussions - English.docx Instructions for the Participation in Focus Group Discussions - English	IC Document
Attachment G1 - Instructions for the Participation in Focus Group Discussions - Spanish.docx Instructions for the Participation in Focus Group Discussions - Spanish	IC Document
SSA (0920-0932) Dengue_Chik_Zika KAP_Travel Consultants and Aid Agencies cpg 05.19.2017.docx Supporting Statement A	IC Document
SSB (0920-0932) Dengue_Chik_Zika KAP_Travel Consultants and Aid Agencies cpg 05.19.2017.docx Supporting Statement B	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

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

Agency IC Tracking Number:

0920-0932-17AML

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
Instruction			Attachment D1 Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteers of Sending Agencies - Spanish (003).docx	NA	No		Paper Only
Form and Instruction	NA	Moderatorâs Guide of Questions for Focus Groups with Sending Agencies - English	Attachment A - Moderator's Guide of Questions for Focus Group 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 A1 - Moderator's Guide of Questions for Focus Group with Sending Agencies - Spanish.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Attachment D Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteers of Sending Agencies - English.docx	NA	No		Paper Only
Instruction			Attachment D1 Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteers of Sending Agencies - Spanish (003).docx	NA	No		Paper Only
Form and Instruction	NA	Moderatorâs Guide of Questions for Focus Groups with Missionairies/Volunteers - English	Attachment B - Moderatorâs Guide for Focus Groups with Missionaries_Volunteers - English.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Moderatorâs Guide of Questions for Focus Groups with Missionairies/Volunteers - Spanish	Attachment B1 - Moderator's Guide for Missionaries_Volunteers - Spanish.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Attachment D Script for Telephone Calls to Screen and Recruit Participants of Focus Groups with Staff and Missionaries_Volunteers of Sending Agencies - English.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: 270

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	270	270
Annual IC Time Burden (Hours)	46	46
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 C - Verbal Consent for Participants for Focus Group regarding Travel Health Messages - English.docx	05/24/2017
Verbal Consent for Participants of Focus Group regarding Travel Health Messages - Spanish	Attachment C1 - Verbal Consent for Participants for Focus Group regarding Travel Health Messages - Spanish.docx	05/24/2017
Project Description	Attachment E - Protocol 6009 Knowledge Attitudes and Practices about Travel Health among Aid Agency Staff and Volunteers.docx	05/24/2017
Research Determination - Exemtion of Amendment	Attachment F - Exemption Determination Letter.docx	05/24/2017
Instructions for the Participation in Focus Group Discussions - English	Attachment G - Instructions for the Participation in Focus Group Discussions - English.docx	05/24/2017
Instructions for the Participation in Focus Group Discussions - Spanish	Attachment G1 - Instructions for the Participation in Focus Group Discussions - Spanish.docx	05/24/2017
Supporting Statement A	SSA (0920-0932) Dengue_Chik_Zika KAP_Travel Consultants and Aid Agencies cpg 05.19.2017.docx	05/24/2017
Supporting Statement B	SSB (0920-0932) Dengue_Chik_Zika KAP_Travel Consultants and Aid Agencies cpg 05.19.2017.docx	05/24/2017

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