Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention

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⚠️ Notice: This information collection may be referencing outdated material.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
Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention Form and Instruction
Attachment E CDC Foodborne Outbreak Draft Knowledge and Practices Protoc 3.14.19.docx Other-Moderator Guide
Attachment F CDC Foodborne Message Test Guide 3.14.19.docx Other-Moderator Guide with Interview
Recruitment Screener Attachment C Recruitment Phone Script for CDC 3.14.19.docx Form and Instruction
Recruitment Follow-up Contact Attachment B CDC Foodborne recruitment communication 3.14.19.docx Form and Instruction
Supporting Statement A (0920-1154).docx Supporting Statement A IC Document
Supporting Statement B (0920-1154).docx Supporting Statement B IC Document
Attachment A Sampling Plan12.18.18.docx Sampling Plan IC Document
Attachment D Consent Forms12.18.18.docx Consent IC Document
Attachment G Messages to Test 1.28.18.docx Messages to Test IC Document
Attachment H Non-research Determination.pdf Nonresearch Determination IC Document
GenIC Request Template.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention	Agency IC Tracking Number:	0920-1154-19ACH

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Recruitment Screener	Attachment C Recruitment Phone Script for CDC 3.14.19.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Recruitment Follow-up Contact	Attachment B CDC Foodborne recruitment communication 3.14.19.docx	Yes	Yes	Fillable Fileable
Other-Moderator Guide			Attachment E CDC Foodborne Outbreak Draft Knowledge and Practices Protoc 3.14.19.docx	Yes	No	Paper Only
Other-Moderator Guide with Interview			Attachment F CDC Foodborne Message Test Guide 3.14.19.docx	Yes	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 804	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 93 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	804	804
Annual IC Time Burden (Hours)	157	157
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	Supporting Statement A (0920-1154).docx	03/14/2019
Supporting Statement B	Supporting Statement B (0920-1154).docx	03/14/2019
Sampling Plan	Attachment A Sampling Plan12.18.18.docx	03/14/2019
Consent	Attachment D Consent Forms12.18.18.docx	03/14/2019
Messages to Test	Attachment G Messages to Test 1.28.18.docx	03/14/2019
Nonresearch Determination	Attachment H Non-research Determination.pdf	03/14/2019
Request for Approval	GenIC Request Template.docx	03/14/2019

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