Team Nutrition Educational Technology Environmental Scan

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
Attachment A_Consent Package for School Focus Groups.docx Other-Attachment A_Consent Package f
Attachment B_Consent Package for SHAPE Conference Focus Groups.docx Other-Attachment B_Consent Package f
Attachment C_Consent Package for Teacher of Health Education Survey.docx Other-Attachment C_Consent Package f
Attachment D_Moderators Guide for Teacher Focus Groups.docx Other-Attachment D_Moderators Guide
Attachment E_Teacher of Health Education Survey.docx Other-Attachment E_Teacher of Health
Attachment F_Flyer for Focus Group Participation.pdf Other-Attachment F_Flyer for Focus G
Attachment G_Introduction Email for School Focus Groups.docx Other-Attachment G_Introduction Emai
Attachment H_Scheduling Email for School Focus Groups.docx Other-Attachment H_Scheduling Email
Attachment I_Principal Letter of Agreement.docx Other-Attachment I_Principal Letter
Attachment J_Introduction Email for Teacher of Health Education Survey.docx Other-Attachment J_Introduction Emai
Environmental Scan_OMB Memo_Final Revised2.pdf Environmental Scan_OMB Memo_Final Revised2 IC Document

Information Collection (IC) Details

IC Title:	Team Nutrition Educational Technology Environmental Scan	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment A_Consent Package for School Focus Groups	Attachment A_Consent Package for School Focus Groups.docx	No	Paper Only
Other-Attachment B_Consent Package for SHAPE Conference Focus Groups	Attachment B_Consent Package for SHAPE Conference Focus Groups.docx	No	Paper Only
Other-Attachment C_Consent Package for Teacher of Health Education Survey	Attachment C_Consent Package for Teacher of Health Education Survey.docx	No	Paper Only
Other-Attachment D_Moderators Guide for Teacher Focus Groups	Attachment D_Moderators Guide for Teacher Focus Groups.docx	No	Paper Only
Other-Attachment E_Teacher of Health Education Survey	Attachment E_Teacher of Health Education Survey.docx	No	Paper Only
Other-Attachment F_Flyer for Focus Group Participation	Attachment F_Flyer for Focus Group Participation.pdf	No	Paper Only
Other-Attachment G_Introduction Email for School Focus Groups	Attachment G_Introduction Email for School Focus Groups.docx	No	Paper Only
Other-Attachment H_Scheduling Email for School Focus Groups	Attachment H_Scheduling Email for School Focus Groups.docx	No	Paper Only
Other-Attachment I_Principal Letter of Agreement	Attachment I_Principal Letter of Agreement.docx	No	Paper Only
Other-Attachment J_Introduction Email for Teacher of Health Education Survey	Attachment J_Introduction Email for Teacher of Health Education Survey.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,980	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,980	2,980
Annual IC Time Burden (Hours)	501	501
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Environmental Scan_OMB Memo_Final Revised2	Environmental Scan_OMB Memo_Final Revised2.pdf	06/20/2016

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