Information Collection

Developing Effective Messages about Excessive Alcohol Consumption: Enhanced Message Development and Testing - Revised Screener

IC 239722 under ICR 201806-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0572 Developing Effective Messages about Excessive Alcohol Consumption: Enhanced Message Development and Testing - Revised Screener	Form and Instruction
0920-0572 Focus Group Screener - Revised 0572 CDC Enhanced Message Development Focus Group Screener_1 31 2020.docx	Form and Instruction
0572 CDC Enhanced Message Development Audience Segmentation Survey 1 31 2020.docx Audience Segmentation Survey	IC Document
0572 CDC Enhanced Message Development Focus Group Discussion Guide 1 31 2020.docx Focus Group Discussion Guide	IC Document
HMTS Expedited Review Form - CDC Alcohol_Message Testing Focus Group Screener.pdf HMTS Expedited Review Form	IC Document
0572 CDC Alcohol - Message Frame - Imagery Worksheet 1 31 2020.docx Imagery Worksheet	IC Document
0572 CDC Alcohol - Message Frame Testing_Ranking Worksheet 1 31 2020.pptx Ranking Worksheet	IC Document
0572 CDC Alcohol - Message Frame Testing Consent Form 1 31 2020.docx Consent Form	IC Document
0572 CDC Alcohol - definition stimuli 1 31 2020.pptx Alcohol Definition Stimuli	IC Document
0572 Protocol Exempt Determination Notice 1 31 2020.pdf IRB Determination	IC Document

IC Title:

Developing Effective Messages about Excessive Alcohol Consumption: Enhanced Message Development and Testing - Revised Screener

Agency IC Tracking Number:

0920-0572-20BX

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	0920-0572	Focus Group Screener - Revised	0572 CDC Enhanced Message Development Focus Group Screener_1 31 2020.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Audience Segmentation Survey	0572 CDC Enhanced Message Development Audience Segmentation Survey 1 31 2020.docx	02/03/2020
Focus Group Discussion Guide	0572 CDC Enhanced Message Development Focus Group Discussion Guide 1 31 2020.docx	02/03/2020
HMTS Expedited Review Form	HMTS Expedited Review Form - CDC Alcohol_Message Testing Focus Group Screener.pdf	02/03/2020
Imagery Worksheet	0572 CDC Alcohol - Message Frame - Imagery Worksheet 1 31 2020.docx	02/03/2020
Ranking Worksheet	0572 CDC Alcohol - Message Frame Testing_Ranking Worksheet 1 31 2020.pptx	02/03/2020
Consent Form	0572 CDC Alcohol - Message Frame Testing Consent Form 1 31 2020.docx	02/03/2020
Alcohol Definition Stimuli	0572 CDC Alcohol - definition stimuli 1 31 2020.pptx	02/03/2020
IRB Determination	0572 Protocol Exempt Determination Notice 1 31 2020.pdf	02/03/2020

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