Information Collection Request

Mobile Messaging Intervention to Present New HIV Prevention Options for Men Who have Sex with Men (MSM): Randomized Controlled Trial

ICR 201804-0920-012 · OMB 0920-1209 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Assessment Form Unchanged Available
Verification of Participant Eligibility Form Unchanged Available
Contact Information Form Unchanged Available
Initial Participant Screening for Eligibility Form Unchanged Available
Justification For Change.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-04-23 Available
Signed NCHHSTP M3 PIA.pdf 17AX.pdf Supplementary Document Uploaded 2018-04-23 Available
SSA - for Change.doc Supporting Statement A Uploaded 2018-04-23 Available
Att 7_Written Messages.docx Supplementary Document Uploaded 2017-04-03 Available
Att 6d_University of Pennsylvania IAA.pdf Supplementary Document Uploaded 2017-04-03 Available
Att 6c_University of Michigan IAA.pdf Supplementary Document Uploaded 2017-04-03 Available
Att 6b_Public Health Solutions IAA.pdf Supplementary Document Uploaded 2017-04-03 Available
Att 6a_Emory IRB Letter of Approval.pdf Supplementary Document Uploaded 2017-04-03 Available
Att 5_Consent Form.doc Supplementary Document Uploaded 2017-04-03 Available
Att 3_Recruitment Materials.docx Supplementary Document Uploaded 2017-04-03 Available
Att 2 60 Day FRN.pdf Supplementary Document Uploaded 2017-04-03 Available
Att 1_Auth Legislation.docx Supplementary Document Uploaded 2017-04-03 Available
SSB_4-07-2017_Word 97-2003.doc Supporting Statement B Uploaded 2017-04-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
226274 Assessment Form Unchanged
226273 Verification of Participant Eligibility Form Unchanged
226272 Contact Information Form Unchanged
226271 Initial Participant Screening for Eligibility Form Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2019 12/31/2019 12/31/2019
5,587 0 5,587
3,787 0 3,787
87,980 0 87,980





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,587 5,587 0 0 0 0
Annual Time Burden (Hours) 3,787 3,787 0 0 0 0
Annual Cost Burden (Dollars) 87,980 87,980 0 0 0 0


Reginfo record details
  No