Information Collection

Focus Groups on Childhood Obesity with Hispanic Primary Caregivers (CFSAN)

IC 239878 under ICR 201911-0910-015 · OMB 0910-0497.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0497 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix I - Participant Screener.docx	Other-Survey Instrument
Appendix II - Moderator Guide.docx	Other-Moderator Guide
Consent Form.docx	Other-Participant Consent Form
0497 Approval Memo Childhood Obesity Hispanic Primary Caregivers 2020.docx OMB Approval Memo	IC Document

IC Title:

Focus Groups on Childhood Obesity with Hispanic Primary Caregivers (CFSAN)

Agency IC Tracking Number:

CFSAN

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Instrument	Appendix I - Participant Screener.docx	Yes	No	Paper Only
Other-Moderator Guide	Appendix II - Moderator Guide.docx	Yes	No	Paper Only
Other-Participant Consent Form	Consent Form.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: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	266	266
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Approval Memo	0497 Approval Memo Childhood Obesity Hispanic Primary Caregivers 2020.docx	02/10/2020

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