Information Collection

Formative Assessment of the Information Needs of Adapting NIOSH-CPWR toolbox talks for Spanish-speaking construction workers: Phase 1

IC 241061 under ICR 201912-0920-003 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-20LK Formative Assessment of the Information Needs of Adapting NIOSH-CPWR toolbox talks for Spanish-speaking construction workers: Phase 1	Form and Instruction
0920-20LK NIOSH Toolbox Focus Group Guide NIOSH Toolbox Focus Group Guide.pdf	Form and Instruction
GenICRequest_Focus groups.docx GENiC Request	IC Document
Appendix I IRB determination.pdf IRB Approval	IC Document
Statement A_.docx SSA	IC Document
Statement B_.docx SSB	IC Document

IC Title:

Formative Assessment of the Information Needs of Adapting NIOSH-CPWR toolbox talks for Spanish-speaking construction workers: Phase 1

Agency IC Tracking Number:

0920-20LK

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-20LK	NIOSH Toolbox Focus Group Guide	NIOSH Toolbox Focus Group Guide.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	72	72
Annual IC Time Burden (Hours)	108	108
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GENiC Request	GenICRequest_Focus groups.docx	04/01/2020
IRB Approval	Appendix I IRB determination.pdf	04/01/2020
SSA	Statement A_.docx	04/01/2020
SSB	Statement B_.docx	04/01/2020

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