Knowledge, Attitudes, and Practices Individual Questionnaire

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)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1254 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-18ANU Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction
0920-18ANU KAP Adult 6. EN Paper Questionnaire - KAP Adult.docx Form and Instruction
0920-18ANU KAP Older Child 6. EN Paper Questionnaire - KAP Older Child.docx Form and Instruction
0920-18ANU KAP Younger Child 6. EN Paper Questionnaire - KAP Younger Child.docx Form and Instruction
0920-18ANU Spanish KAP Adult 6. ES Paper Questionnaire - KAP Adult.docx Form and Instruction
0920-18ANU Spanish KAP Older Child 6. ES Paper Questionnaire - KAP Older Child.docx Form and Instruction
0920-18ANU Spanish KAP Younger Child 6. ES Paper Questionnaire - KAP Younger Child.docx Form and Instruction
0920-18ANU Year Two Combined Questionnaire 6. Attachment_6 EN ES Y2 Paper Questionnaire - COMBINED 03.25.2019.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Knowledge, Attitudes, and Practices Individual Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	0920-18ANU	KAP Adult	6. EN Paper Questionnaire - KAP Adult.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	KAP Older Child	6. EN Paper Questionnaire - KAP Older Child.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	KAP Younger Child	6. EN Paper Questionnaire - KAP Younger Child.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	Spanish KAP Adult	6. ES Paper Questionnaire - KAP Adult.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	Spanish KAP Older Child	6. ES Paper Questionnaire - KAP Older Child.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	Spanish KAP Younger Child	6. ES Paper Questionnaire - KAP Younger Child.docx	na	No	Fillable Fileable
Form and Instruction	0920-18ANU	Year Two Combined Questionnaire	6. Attachment_6 EN ES Y2 Paper Questionnaire - COMBINED 03.25.2019.pdf	NA	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 4,000	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	4,000	4,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	7,250	7,250

Documents for IC

Title	Document	Date Uploaded
No associated records found

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