Information Collection

Cognitive Interview Study: Spanish-language Telephone-administered Questions for PRAMS (2019)

IC 236479 under ICR 201807-0920-004 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Document Name Document Type
Cognitive Interview Study: Spanish-language Telephone-administered Questions for PRAMS (2019) Form and Instruction
Telephone Screening Script (in Spansih) 0920 0222 Attach 3 Screener Span PRAMS 2019.docx Form and Instruction
PRAMS 2019 questions to be cognitively tested (Phone/Spa 0920 0222 Attach 1 Qnne Span PRAMS 2019.docx Form and Instruction
Respondent Data Sheet (in Spanish) 0920 0222 Attach 5 Resp Data Collect Span PRAMS 2019.docx Form and Instruction
0920-0222 Span PRAMS 2019 10-Day Ltr 6.13.19.docx Project Description and Justification IC Document
0920 0222 Attach 2abc Ad&flyer Span PRAMS 2019.docx Recruitment Advertisements (in Spanish) IC Document
0920 0222 Attach 4 Consent Span PRAMS 2019.docx Consent Form (in Spanish) IC Document
0920 0222 Attach 6 Thank You Span PRAMS 2019.docx Thank You Letter (in Spanish) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cognitive Interview Study: Spanish-language Telephone-administered Questions for PRAMS (2019)	Agency IC Tracking Number:	0920-19BGZ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	n/a	Telephone Screening Script (in Spansih)	0920 0222 Attach 3 Screener Span PRAMS 2019.docx	No	Paper Only
Form and Instruction	n/a	PRAMS 2019 questions to be cognitively tested (Phone/Spanish version)	0920 0222 Attach 1 Qnne Span PRAMS 2019.docx	No	Paper Only
Form and Instruction	n/a	Respondent Data Sheet (in Spanish)	0920 0222 Attach 5 Resp Data Collect Span PRAMS 2019.docx	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	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	80	80
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Project Description and Justification	0920-0222 Span PRAMS 2019 10-Day Ltr 6.13.19.docx	06/13/2019
Recruitment Advertisements (in Spanish)	0920 0222 Attach 2abc Ad&flyer Span PRAMS 2019.docx	06/13/2019
Consent Form (in Spanish)	0920 0222 Attach 4 Consent Span PRAMS 2019.docx	06/13/2019
Thank You Letter (in Spanish)	0920 0222 Attach 6 Thank You Span PRAMS 2019.docx	06/13/2019

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