Information Collection

In-Home Food Safety Behaviors and Consumer Education: Annual Observational Study

IC 226809 under ICR 201803-0583-001 · OMB 0583-0169.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appx E_Screening Questionnaires_6_28_17.docx Other-screening questionnaires
Appx E_Screening Questionnaires__Span 11_7_17.docx Other-screening questionnaires Spani
Appx E_Screening Questionnaires__Eng and Span_3_9_18.docx Other-screening questionnaires Year
Appx A_study design.docx
Study Design
IC Document
Appx B_recruiting ads.docx
Recruiting Ads
IC Document
Appx C_Recruiting Email.docx
Recruiting Email
IC Document
Appx D_Recruiting Sign.docx
Recruiting Sign
IC Document
Appx F_Recruit Call Script.docx
Recruiting Call Script
IC Document
Appx G_Confirmation Email.docx
Confirmation Email
IC Document
Appx H_Reminder Call Script.docx
Reminder Call Script
IC Document
Appx J_Consent Form_5_10_17.docx
Consent Form
IC Document
Appx L_Recipes and Instructions.docx
Recipes and Instructions
IC Document
Appx B_recruiting ads_Span 11_7_17.docx
Recruiting Ads Spanish
IC Document
Appx C_Recruiting Email_Span 11_7_17.docx
Recruiting Email Spanish
IC Document
Appx D_Recruiting Sign_Span 11_7_17.docx
Recruiting Sign Spanish
IC Document
Appx F_Recruit Call Script_Span 11_7_17.docx
Recruiting Call Script Spanish
IC Document
Appx G_Confirmation Email_Span 11_7_17.docx
Confirmation Email Spanish
IC Document
Appx H_Reminder Call Script_Span 11_7_17.docx
Reminder Call Script Spanish
IC Document
Appx J_Consent Form_Span 11_7_17.docx
Consent Form Spanish
IC Document
Appx L_Recipes and Instructions_Span 11_7_17.docx
Recipes and Instructions Spanish
IC Document
Appx A_study design_poultry rinsing_3_9_18.docx
Study Design Year 2
IC Document
Appx G_Confirmation Email__Eng and Span_3_9_18.docx
Confirmation Email Year 2
IC Document
Appx J_Consent Form__Eng and Span_3_9_18.docx
Consent Form Year 2
IC Document
Appx L_Recipes and Instructions__Eng and Span_3_9_18.docx
Recipes and Instructions Year 2
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-screening questionnaires No   Paper Only
Other-screening questionnaires Spanish No   Paper Only
Other-screening questionnaires Year 2 No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,999 0 0 0 0 1,999
Annual IC Time Burden (Hours) 2,942 0 0 0 0 2,942
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Study Design 05/17/2017
Recruiting Ads 05/17/2017
Recruiting Email 05/17/2017
Recruiting Sign 05/17/2017
Recruiting Call Script 05/17/2017
Confirmation Email 05/17/2017
Reminder Call Script 05/17/2017
Consent Form 05/17/2017
Recipes and Instructions 05/17/2017
Recruiting Ads Spanish 11/14/2017
Recruiting Email Spanish 11/14/2017
Recruiting Sign Spanish 11/14/2017
Recruiting Call Script Spanish 11/14/2017
Confirmation Email Spanish 11/14/2017
Reminder Call Script Spanish 11/14/2017
Consent Form Spanish 11/14/2017
Recipes and Instructions Spanish 11/14/2017
Study Design Year 2 03/15/2018
Confirmation Email Year 2 03/15/2018
Consent Form Year 2 03/15/2018
Recipes and Instructions Year 2 03/15/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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