Information Collection

Health Communication Message Testing on Tuberculosis

IC 235026 under ICR 201808-0920-023 · OMB 0920-0840.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Document Name Document Type
Health Communication Message Testing on Tuberculosis Form and Instruction
Att 1a_Moderator'sGuide.docx Other-Moderator's Guide
Recruitment Screener Att 1b_RecruitmentScreener-CLEAN.docx Form and Instruction
SSB_DTBE-CLEAN.docx Supporting Statement B IC Document
Att 2a_Email-NoIRBNeeded.pdf IRB Letter IC Document
Att 3_ThemesandMessages.docx Topics and messages for testing IC Document
Att 4_EducationalPowerPoint.pdf TB Powerpoint IC Document
SSA_DTBE-2.28.19-Clean.docx Supporting Statement A IC Document
PT2 Wrk Att1b_Screener.pdf PT2 Wrk Att1b_Screener IC Document
PT2 Wrk Att 1a_Moderator.pdf Pt2 Wrk Att1a_Moderator IC Document
Att 2b_Project-Determination-and-Approval-Form.pdf Research Determination IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Health Communication Message Testing on Tuberculosis	Agency IC Tracking Number:	0920-0840-19YE

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	none	Recruitment Screener	Att 1b_RecruitmentScreener-CLEAN.docx		Yes	Yes	Fillable Fileable
Other-Moderator's Guide			Att 1a_Moderator'sGuide.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,885	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,885	6,885
Annual IC Time Burden (Hours)	1,080	1,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement B	SSB_DTBE-CLEAN.docx	02/21/2019
IRB Letter	Att 2a_Email-NoIRBNeeded.pdf	02/21/2019
Topics and messages for testing	Att 3_ThemesandMessages.docx	02/21/2019
TB Powerpoint	Att 4_EducationalPowerPoint.pdf	02/21/2019
Supporting Statement A	SSA_DTBE-2.28.19-Clean.docx	02/28/2019
PT2 Wrk Att1b_Screener	PT2 Wrk Att1b_Screener.pdf	02/28/2019
Pt2 Wrk Att1a_Moderator	PT2 Wrk Att 1a_Moderator.pdf	02/28/2019
Research Determination	Att 2b_Project-Determination-and-Approval-Form.pdf	02/28/2019

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