Information Collection

Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers

IC 238224 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⚠️ Notice: This information collection may be referencing outdated material.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
Focus Group Guide - English_Spanish 10-29-19.docx	Other-Focus Group Guide
GenICRequest_Focus groups_Skin_Cancer_110619.docx Request for Approval	IC Document
Statement A_110519 Clean.docx Supporting Statement A	IC Document
Statement B_110419Clean.docx Supporting Statement B	IC Document
Recruitment_Consent_Form_English_Spanish 102919.docx Consent	IC Document
Att II. DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers_2019 Aug 30.pdf Research Determination	IC Document
Att I. OSH Act.doc Authorizing legislation	IC Document

IC Title:

Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers

Agency IC Tracking Number:

0920-1154-20BF

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Guide			Focus Group Guide - English_Spanish 10-29-19.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	GenICRequest_Focus groups_Skin_Cancer_110619.docx	11/06/2019
Supporting Statement A	Statement A_110519 Clean.docx	11/06/2019
Supporting Statement B	Statement B_110419Clean.docx	11/06/2019
Consent	Recruitment_Consent_Form_English_Spanish 102919.docx	11/06/2019
Research Determination	Att II. DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers_2019 Aug 30.pdf	11/06/2019
Authorizing legislation	Att I. OSH Act.doc	11/06/2019

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