Youth Online Screener– Outcome Survey

Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.

OMB: 0910-0788

IC ID: 215947

Information Collection (IC) Details

View Information Collection (IC)

Youth Online Screener– Outcome Survey
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Longitudinal Web Consent and Assent Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx Yes Yes Printable Only
Other-Longitudinal Web Consent 18+ Year Old Youth Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU5.docx Yes Yes Printable Only
Other-Youth Assent Longitudinal Age 15 - 17 Social Media Permission Waived Web Attachment 05i_Youth Assent_ Age 15 - 17_Social Media_Permission Waived_Web_FU5.docx Yes Yes Fillable Fileable
Other-Outcome Web Screener Attachment 03_EFECT_Outcome_Web_Screener_FU5.docx Yes Yes Fillable Fileable
Other-Cross Sectional Social Media_Snowball 15+ Youth Attachment 05e_Youth Assent_Cross Sectional Age 15 - 17_Social Media_Web_FU5.docx Yes Yes Fillable Fileable
Other-Youth Assent Cross Sectional Age 13 - 14 Social Media Web Attachment 05f_Youth Assent_Cross Sectional Age 13 - 14_Social Media_Web_FU5.docx Yes Yes Fillable Fileable
Other-Youth Assent Longitudinal Age 13 - 17 Social Media Web Attachment 05g_Youth Assent_Longitudinal Age 13 - 17_Social Media_Web_FU5.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety


40,000 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 40,000 0 0 0 0 40,000
Annual IC Time Burden (Hours) 3,332 0 0 0 0 3,332
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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