Information Collection Request

Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)

ICR 201812-0920-004 · OMB 0920-1254 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-18ANU Specimen Collection Form and Instruction New Available
Form 0920-18ANU Vector Control Intervention Questionnaire Form and Instruction New Available
Form 0920-18ANU Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction New Available
Form 0920-18ANU Individual Questionnaire Form and Instruction New Available
Form 0920-18ANU Household Representative Questionnaire Form and Instruction New Available
11. PIA_COPA.pdf Supplementary Document Uploaded 2018-12-20 Available
10. COPA Flyer.pdf Supplementary Document Uploaded 2018-12-20 Available
9. IRB Approval Letter.pdf Supplementary Document Uploaded 2018-12-20 Repair queued
3. Consent Form - Spanish.docx Supplementary Document Uploaded 2018-12-20 Available
3. Consent Form - English.docx Supplementary Document Uploaded 2018-12-20 Available
2. 60-Day FRN.pdf Supplementary Document Uploaded 2018-12-20 Available
1. Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-12-20 Available
SSB COPA NEW_after OMB review_3-21-2019_GPB_clean.docx Supporting Statement B Uploaded 2019-03-26 Available
SSA COPA NEW final_edits after OMB_3-21-2019-GPB_clean.docx Supporting Statement A Uploaded 2019-03-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
234597 Specimen Collection Form and Instruction New
234596 Vector Control Intervention Questionnaire Form and Instruction New
234595 Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction New
234594 Individual Questionnaire Form and Instruction New
234590 Household Representative Questionnaire Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2022 36 Months From Approved
16,120 0 0
3,471 0 0
25,166 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,120 0 0 16,120 0 0
Annual Time Burden (Hours) 3,471 0 0 3,471 0 0
Annual Cost Burden (Dollars) 25,166 0 0 25,166 0 0


Reginfo record details
  No