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Federal forms, ICRs, and supporting documents

Information Collection

Focus Group Testing to Effectively Plan and Tailor a Young Women and Breast Cancer Communication Campaign

IC 235525 under ICR 201808-0920-001 · OMB 0920-0800.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Focus Group Testing to Effectively Plan and Tailor a Young Women and Breast Cancer Communication Campaign 0920-0800-19AJF
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0800 Discussion Guide for Hispanic (family history) Eng Attachment B1. Discussion Guide for Hispanic (Family History)_English 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for Hispanic (family history) Spa Attachment B2. Discussion Guide for Hispanic (Family History)_Spanish 3-14-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for Hispanic (no fam hist) Eng Attachment B3. Discussion Guide for Hispanic (No Family History)_English 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for Hispanic (no fam hist) Spa Attachment B4. Discussion Guide for Hispanic (No Family History)_Spanish 3-14-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for AA (family history) Attachment C1. Discussion Guide for AA (With Family History) 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for AA (no fam hist) Attachment C2. Discussion Guide for AA (Without Family History) 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for AIAN (family history) Attachment D1. Discussion Guide for AIAN (Family History) 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Discussion Guide for AIAN (no fam hist) Attachment D2. Discussion Guide for AIAN (No Family History) 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Screening Instrument Hispanic Eng Attachment E1. Screening Instrument for Hispanic Young Women_English 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Screening Instrument Hispanic Spa Attachment E2. Screening Instrument for Hispanic Young Women_Spanish 3-14-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Screening Instrument AA Attachment F. Screening Instrument for African American Young Women 2-4-19.docx No   Fillable Fileable
Form and Instruction 0920-0800 Screening Instrument AIAN Attachment G. Screening Instrument for AIAN Young Women 2-4-19.docx No   Fillable Fileable

Health Illness Prevention

 

594 0
   
Individuals or Households
 
   0 %

  Approved 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 594 0 594 0 0 0
Annual IC Time Burden (Hours) 317 0 317 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Legislative Authority Attachment A. Legislative Authority - EARLY Act Reauthorization.pdf 03/29/2019
Materials for Testing Hispanic Eng Attachment B5. Materials for Testing_Hispanic Young Women_English.pdf 03/29/2019
Materials for Testing Hispanic Spa Attachment B6. Materials for Testing_Hispanic Young Women_Spanish.pdf 03/29/2019
Materials for Testing AA Attachment C3. Materials for Testing_AA Young Women 2-4-19.pdf 03/29/2019
Materials for Testing AIAN Attachment D3. Materials for Testing_AIAN Young Women.pdf 03/29/2019
Participant Information Sheet Eng Attachment H1. Participant Information Sheet_English.docx 03/29/2019
Participant Information Sheet Spa Attachment H2. Participant Information Sheet_Spanish.docx 03/29/2019
SSA Supporting Statement Part A_v5 3-15-19 final.doc 03/29/2019
SSB Supporting Statement Part B_v5 3-15-19.docx 03/29/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.