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Foundational Focus Groups
ASPA COVID-19 Public Education Campaign Market Research
OMB: 0990-0476
IC ID: 245351
OMB.report
HHS/HHSDM
OMB 0990-0476
ICR 202102-0990-002
IC 245351
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0476 can be found here:
2023-06-13 - No material or nonsubstantive change to a currently approved collection
2023-06-05 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Part A - Attachment D_Foundational FGs Invitation Emails.docx
Other-FFG- Part A, Attachment D
Part A - Attachment E_ Foundational FGs Screener_122420.docx
Other-FFG-Part A, Attachment E
Part A - Attachment F_Foundational FGs Informed Consent Form_122420.docx
Other-FFG-Part A, Attachment F
Part A - Attachment G_Foundational FGs External IRB Determination.pdf
Other-FFG-Part A, Attachment G
Part B - Attachment B_Foundational FGs Discussion Guide_011821.docx
Other-FFG-Part B, Attachment B
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Foundational Focus Groups
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Other-FFG- Part A, Attachment D
Part A - Attachment D_Foundational FGs Invitation Emails.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment E
Part A - Attachment E_ Foundational FGs Screener_122420.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment F
Part A - Attachment F_Foundational FGs Informed Consent Form_122420.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment G
Part A - Attachment G_Foundational FGs External IRB Determination.pdf
Yes
Yes
Fillable Fileable
Other-FFG-Part B, Attachment B
Part B - Attachment B_Foundational FGs Discussion Guide_011821.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
20,000
0
0
0
0
20,000
Annual IC Time Burden (Hours)
3,096
0
0
0
0
3,096
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.