Constituent Feedback to Oral Health Education Messages and Materials

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 244935

Documents and Forms
Document Name
Document Type
Form
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IC Document
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Information Collection (IC) Details

View Information Collection (IC)

Constituent Feedback to Oral Health Education Messages and Materials
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1-1 RS attachment 1 - focus group participant recruitment screener.docx attachment 1 - focus group participant recruitment screener.docx Yes Yes Fillable Fileable
Form 1-2 RS attachment 2 - cognitive interview participant recruitment screener.docx attachment 2 - cognitive interview participant recruitment screener.docx Yes Yes Fillable Fileable
Form 1-3 RS attachment 3 - online discussion board participant recruitment screener.docx attachment 3 - online discussion board participant recruitment screener.docx Yes Yes Fillable Fileable
Form 2-1 EP attachment 4 - focus group evaluation protocols.docx attachment 4 - focus group evaluation protocols.docx Yes Yes Fillable Fileable
Form 2-2 EP attachment 5 - cognitive interview evaluation protocols.docx attachment 5 - cognitive interview evaluation protocols.docx Yes Yes Fillable Fileable
Form 2-3 EP attachment 6 - online discussion board evaluation protocols.docx attachment 6 - online discussion board evaluation protocols.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

308 0
   
Individuals or Households
 
   100 %

  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 308 0 308 0 0 0
Annual IC Time Burden (Hours) 182 0 182 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A FINALsupporting statement a.docx 12/15/2020
attachment 7 - brushing and flossing brochure attachment 7 - brushing and flossing brochure.pdf 12/15/2020
attachment 8 - dry mouth brochure attachment 8 - dry mouth brochure.pdf 12/15/2020
attachment 9 - oral cancer brochure attachment 9 - oral cancer brochure.pdf 12/15/2020
attachment 10 - baby's oral health brochure attachment 10 - baby's oral health brochure.pdf 12/15/2020
attachment 11 - brushing child's teeth brochure attachment 11 - brushing child's teeth brochure.pdf 12/15/2020
attachment 12 - oral health and HIV brochure attachment 12 - oral health and HIV brochure.pdf 12/15/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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