Information Collection

Reframing How We Talk About Alcohol

IC 226269 under ICR 201610-0920-009 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Reframing How We Talk About Alcohol	Form and Instruction
Att. B- Phase 1 In-depth Interview and Triad Guide.docx	Other-Moderator Guide
Att. D- Phase 2 In-depth Interview and Triad Guide.docx	Other-Moderator Guide
Screener Att. A-Screening Instrument.docx	Form and Instruction
GenICRequest_Public Perception of Alcohol_032417.docx Request for Approval	IC Document
Supporting Statement A_Reframing Alcohol_April 3 2017.doc Supporting Statement A	IC Document
Support Statement B_ Reframing How We Talk About Alcohol.docx Supporting Statement B	IC Document
Att. E- In-Depth Interview Consent Form.docx Interview consent	IC Document
Att. F- Triad Discussion Consent Form.docx Discussion consent	IC Document
Att. G - IRB Approval Letter.pdf IRB Approval	IC Document
Att. C - SampleMessagesImages_Activity.docx Sample messages	IC Document

IC Title:

Reframing How We Talk About Alcohol

Agency IC Tracking Number:

17ACB

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Screener	Att. A-Screening Instrument.docx	Yes	Yes	Fillable Fileable
Other-Moderator Guide			Att. B- Phase 1 In-depth Interview and Triad Guide.docx	Yes	Yes	Fillable Fileable
Other-Moderator Guide			Att. D- Phase 2 In-depth Interview and Triad Guide.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 354

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	354	354
Annual IC Time Burden (Hours)	132	132
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	GenICRequest_Public Perception of Alcohol_032417.docx	04/03/2017
Supporting Statement A	Supporting Statement A_Reframing Alcohol_April 3 2017.doc	04/03/2017
Supporting Statement B	Support Statement B_ Reframing How We Talk About Alcohol.docx	04/03/2017
Interview consent	Att. E- In-Depth Interview Consent Form.docx	04/03/2017
Discussion consent	Att. F- Triad Discussion Consent Form.docx	04/03/2017
IRB Approval	Att. G - IRB Approval Letter.pdf	04/03/2017
Sample messages	Att. C - SampleMessagesImages_Activity.docx	04/03/2017

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