Testing Health Communication Messages to Promote Hand Hygiene Behavior Among U.S. Adults

CDC and ATSDR Health Message Testing System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0572 Testing Health Communication Messages to Promote Hand Hygiene Behavior Among U.S. Adults Form and Instruction
0920-0572 Interview Guide 5. Interview Guide.docx Form and Instruction
0920-0572 Screening Form 2. Screening Form final.docx Form and Instruction
1. Recruitment Flyer.docx Recruitment Flyer IC Document
3. Notification Scripts.docx Notification Scripts IC Document
4. Consent Form.docx Consent Form IC Document
6. Non-research determination.pdf Non-Research Determination IC Document
18_299080-A_Frankson_Handwashing Poster_no logo.pdf Handwashing Poster IC Document
HH-posters-v4-Man in MIrror-1_ Option 1_010318.jpg Man-in-Mirror Poster IC Document
HH-posters-v4-Mom and Child-2_Option 2.jpg Mom and Child Poster IC Document
HMTS Expedited Review Form HH Message Testing.20190103.pdf Review Form Template IC Document

Information Collection (IC) Details

IC Title:	Testing Health Communication Messages to Promote Hand Hygiene Behavior Among U.S. Adults	Agency IC Tracking Number:	0920-0572-19NL

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0572	Interview Guide	5. Interview Guide.docx	NA	No		Fillable Fileable
Form and Instruction	0920-0572	Screening Form	2. Screening Form final.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 520	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	520	520
Annual IC Time Burden (Hours)	104	104
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Flyer	1. Recruitment Flyer.docx	01/24/2019
Notification Scripts	3. Notification Scripts.docx	01/24/2019
Consent Form	4. Consent Form.docx	01/24/2019
Non-Research Determination	6. Non-research determination.pdf	01/24/2019
Handwashing Poster	18_299080-A_Frankson_Handwashing Poster_no logo.pdf	01/24/2019
Man-in-Mirror Poster	HH-posters-v4-Man in MIrror-1_ Option 1_010318.jpg	01/24/2019
Mom and Child Poster	HH-posters-v4-Mom and Child-2_Option 2.jpg	01/24/2019
Review Form Template	HMTS Expedited Review Form HH Message Testing.20190103.pdf	01/24/2019

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