Formative Research on Resilience and Transgender Youth

Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Document Name Document Type
Formative Research on Resilience and Transgender Youth Form and Instruction
Qualitative Interview Guide Att 3 Qualitative InDepth Interview Guide.docx Form and Instruction
Eligibility Screener Att 6 Eligibility Screener.docx Form and Instruction
Att 1-Section 301 of the PHSA.PDF Authorizing Legislation IC Document
Att 2 60 Day FRN.PDF 60-day FRN for the Generic IC Document
Att 4a Consent Form(Age 18+).docx Consent Form for Ages 18+ IC Document
Att 4b Assent Form(Age 15-17).docx Assent Form for Ages 15-17 IC Document
Att 5-Recruitment Flyer and Palmcard Text.docx Recruitment Flyer and Palmcard Text IC Document
Att 7- Interviewer Form.docx Interviewer Form (for staff use only) IC Document
Att 8-Memorandum of Understanding with CBOs.docx MOU with Community Based Organizations IC Document
Att 9- Atlanta Metro Resources.docx Atlanta Metro Resources IC Document
Att 10 IRB Approvals CDCICF.DOCX IRB Documentation for CDC and ICF IC Document
SSA_10 14 2016.docx Supporting Statement A IC Document
SSB_10 14 2016.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	Formative Research on Resilience and Transgender Youth	Agency IC Tracking Number:	0920-16BFO

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Qualitative Interview Guide	Att 3 Qualitative InDepth Interview Guide.docx		No		Paper Only
Form and Instruction	N/A	Eligibility Screener	Att 6 Eligibility Screener.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 252

Number of Respondents: 48	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	73	73
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Legislation	Att 1-Section 301 of the PHSA.PDF	10/14/2016
60-day FRN for the Generic	Att 2 60 Day FRN.PDF	10/14/2016
Consent Form for Ages 18+	Att 4a Consent Form(Age 18+).docx	10/14/2016
Assent Form for Ages 15-17	Att 4b Assent Form(Age 15-17).docx	10/14/2016
Recruitment Flyer and Palmcard Text	Att 5-Recruitment Flyer and Palmcard Text.docx	10/14/2016
Interviewer Form (for staff use only)	Att 7- Interviewer Form.docx	10/14/2016
MOU with Community Based Organizations	Att 8-Memorandum of Understanding with CBOs.docx	10/14/2016
Atlanta Metro Resources	Att 9- Atlanta Metro Resources.docx	10/14/2016
IRB Documentation for CDC and ICF	Att 10 IRB Approvals CDCICF.DOCX	10/14/2016
Supporting Statement A	SSA_10 14 2016.docx	10/14/2016
Supporting Statement B	SSB_10 14 2016.docx	10/14/2016

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