Information Collection

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

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0169 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document 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)

IC Title:

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

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-screening questionnaires	Appx E_Screening Questionnaires_6_28_17.docx	No	Paper Only
Other-screening questionnaires Spanish	Appx E_Screening Questionnaires__Span 11_7_17.docx	No	Paper Only
Other-screening questionnaires Year 2	Appx E_Screening Questionnaires__Eng and Span_3_9_18.docx	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,999

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	Previously Approved
Annual Number of Responses for this IC	1,999	1,999
Annual IC Time Burden (Hours)	2,942	2,942
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Study Design	Appx A_study design.docx	05/17/2017
Recruiting Ads	Appx B_recruiting ads.docx	05/17/2017
Recruiting Email	Appx C_Recruiting Email.docx	05/17/2017
Recruiting Sign	Appx D_Recruiting Sign.docx	05/17/2017
Recruiting Call Script	Appx F_Recruit Call Script.docx	05/17/2017
Confirmation Email	Appx G_Confirmation Email.docx	05/17/2017
Reminder Call Script	Appx H_Reminder Call Script.docx	05/17/2017
Consent Form	Appx J_Consent Form_5_10_17.docx	05/17/2017
Recipes and Instructions	Appx L_Recipes and Instructions.docx	05/17/2017
Recruiting Ads Spanish	Appx B_recruiting ads_Span 11_7_17.docx	11/14/2017
Recruiting Email Spanish	Appx C_Recruiting Email_Span 11_7_17.docx	11/14/2017
Recruiting Sign Spanish	Appx D_Recruiting Sign_Span 11_7_17.docx	11/14/2017
Recruiting Call Script Spanish	Appx F_Recruit Call Script_Span 11_7_17.docx	11/14/2017
Confirmation Email Spanish	Appx G_Confirmation Email_Span 11_7_17.docx	11/14/2017
Reminder Call Script Spanish	Appx H_Reminder Call Script_Span 11_7_17.docx	11/14/2017
Consent Form Spanish	Appx J_Consent Form_Span 11_7_17.docx	11/14/2017
Recipes and Instructions Spanish	Appx L_Recipes and Instructions_Span 11_7_17.docx	11/14/2017
Study Design Year 2	Appx A_study design_poultry rinsing_3_9_18.docx	03/15/2018
Confirmation Email Year 2	Appx G_Confirmation Email__Eng and Span_3_9_18.docx	03/15/2018
Consent Form Year 2	Appx J_Consent Form__Eng and Span_3_9_18.docx	03/15/2018
Recipes and Instructions Year 2	Appx L_Recipes and Instructions__Eng and Span_3_9_18.docx	03/15/2018

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