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

CDC/ATSDR Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.