Longitudinal Cohort Youth Assent/Consent Process and Post-Tests 1-5 – Outcome Survey

Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.

OMB: 0910-0788

IC ID: 215944

Documents and Forms
Document Name
Document Type
Other-Post Campaign Instrument.
Other-Outcome Parent Lead Letter Lon
Other-Parent Second Mailing
Other-Unable to Contact Letters
Other-Verification Call Script
Other-Verification Call Script Age 1
Other-Parental Permission Youth Asse
Other-Parental Permission Youth Asse
Other-Informed Consent Longitudinal
Other-Youth Assent Longitudinal Age
Other-Youth Assent_Longitudinal Age
Information Collection (IC) Details

View Information Collection (IC)

Longitudinal Cohort Youth Assent/Consent Process and Post-Tests 1-5 – Outcome Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Post Campaign Instrument. Attachment 01_Post Campaign Instrument_FU4.docx Yes Yes Fillable Fileable
Other-Outcome Parent Lead Letter Longitudinal Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU4.docx No   Paper Only
Other-Parent Second Mailing Attachment 10_Parent Second Mailing_FU4.docx No   Paper Only
Other-Unable to Contact Letters Attachment 13_Unable to Contact Letters_FU4.docx No   Paper Only
Other-Verification Call Script Attachment 17_Verification Call Script_Age 13-17.docx No   Printable Only
Other-Verification Call Script Age 18 Attachment 17a_Verification Call Script Age 18_NEW.docx No   Printable Only
Other-Parental Permission Youth Assent Longitudinal Age 12-17 (Household) Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU4.docx No   Paper Only
Other-Parental Permission Youth Assent Longitudinal Age 12-17 (Web) Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU4.docx Yes Yes Fillable Printable
Other-Informed Consent Longitudinal Age 18 (Web) Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU4.docx No   Paper Only
Other-Youth Assent Longitudinal Age 13 - 17 Social Media (Web) Attachment 05g_Youth Assent_Longitudinal Age 13 - 17_Social Media_Web_FU4.docx Yes Yes Fillable Printable
Other-Youth Assent_Longitudinal Age 15 - 17 Social Media Permission Waived (Web) Attachment 05i_Youth Assent_Longitudinal Age 15 - 17_Social Media_Permission Waived_Web_FU4.docx Yes Yes Fillable Printable

Health Consumer Health and Safety

 

6,039 0
   
Individuals or Households
 
   0 %

  Requested 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 6,039 0 0 1,200 0 4,839
Annual IC Time Burden (Hours) 4,530 0 0 900 0 3,630
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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