Persuasive Communication about Risks from and Responses to Zika: FOCUS GROUPS

CDC/ATSDR Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Persuasive Communication about Risks from and Responses to Zika: FOCUS GROUPS Form and Instruction
Focus Group - Vignette AttH-Vignette.docx Form and Instruction
AttD-RecruitLetter.docx Focus Group - Recruitment Letter IC Document
AttE-ConsentLetter.docx Focus Group - Consent Script IC Document
AttF-HumSubjExempt.docx Research Determination Exemption IC Document
0920-1154-SSA_v2-PersuasiveComm-20170928clean.docx Supporting Statement A IC Document
0920-1154-SSB_v2-PersuasiveComm-20170928clean.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	Persuasive Communication about Risks from and Responses to Zika: FOCUS GROUPS	Agency IC Tracking Number:	0920-1154-17AYO

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	NA	Focus Group - Vignette	AttH-Vignette.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 72	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	72	72
Annual IC Time Burden (Hours)	216	216
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Focus Group - Recruitment Letter	AttD-RecruitLetter.docx	09/28/2017
Focus Group - Consent Script	AttE-ConsentLetter.docx	09/28/2017
Research Determination Exemption	AttF-HumSubjExempt.docx	09/28/2017
Supporting Statement A	0920-1154-SSA_v2-PersuasiveComm-20170928clean.docx	09/28/2017
Supporting Statement B	0920-1154-SSB_v2-PersuasiveComm-20170928clean.docx	09/28/2017

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