Information Collection Request

Identification of Behavioral and Clinical Predictors of Early HIV Infection (Project DETECT)

ICR 202112-0920-002 · OMB 0920-1100 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1100 Att 8b_Phase 2 Behavioral Survey (Spanish) Form Modified Available
Form 0920-1100 Att 11a_Phase 2 Consent form (English) Form Modified Repair queued
Form 0920-1100 Phase 2 Consent Form Modified Repair queued
Form 0920-1100 Att 10b_Phase 1 Consent Form (Spanish) Form and Instruction Modified Repair queued
Form 0920-1100 Phase 1 Consent Form Modified Available
Form 0920-1100 Phase 1 Consent Form Modified Available
Form 0920-1100 Att 8b_Phase 2 Behavioral Survey (Spanish) Form and Instruction Modified Available
Form 0920-1100 Att 8a_Phase 2 Behavioral Survey (English) Form and Instruction Modified Available
Form 0920-1100 Phase 2 Behavioral Survey Form and Instruction Modified Repair queued
Form 0920-1100 Att 9b_Phase 2 HIV Symptom and Care Survey (Spanish) Form and Instruction Modified Available
Form 0920-1100 Att 9a_Phase 2 HIV Symptom and Care Survey (English) Form and Instruction Modified Available
Form 0920-1100 Phase 2 HIV Symptom and Care Survey Form and Instruction Modified Available
Form 0920-1100 Att 7b_Phase 1 Enrollment Survey (Spanish) Form and Instruction Modified Available
Form 0920-1100 Att 7a_Phase 1 Enrollment Survey (English) Form and Instruction Modified Available
Form 0920-1100 Phase 1 Enrollment Survey Form and Instruction Modified Repair queued
Att 13 Project Determination.pdf Supplementary Document Uploaded 2021-12-07 Repair queued
Privacy Act Checklist.docx Supplementary Document Uploaded 2021-12-07 Repair queued
Att 4 IRB approval (JHU_Hamill).pdf Supplementary Document Uploaded 2021-12-07 Repair queued
Att 3_References.docx Supplementary Document Uploaded 2021-12-07 Repair queued
Att 1_Auth Legislation.docx Supplementary Document Uploaded 2021-12-07 Repair queued
Summary of changes to questionnaire - DETECT 2.0 - 03.11.2021.xlsx Supplementary Document Uploaded 2021-03-25 Repair queued
Justification for Change for 0920-1100_DETECT clean_final.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-03-25 Repair queued
Att 15_PIA.pdf Supplementary Document Uploaded 2018-11-16 Repair queued
Att 14_Project Determination.pdf Supplementary Document Uploaded 2018-11-16 Repair queued
Att 13_Supplemental Study Information.docx Supplementary Document Uploaded 2018-11-16 Repair queued
Att 5_IRB Approval.pdf Supplementary Document Uploaded 2018-11-16 Repair queued
Att 4_Certificate of Confidentiality.pdf Supplementary Document Uploaded 2018-11-16 Repair queued
Att 3_References.docx Supplementary Document Uploaded 2018-11-16 Repair queued
Att 2_60-Day FRN Published.pdf Supplementary Document Uploaded 2018-11-16 Repair queued
Att 1_Auth Legislation.docx Supplementary Document Uploaded 2018-11-16 Repair queued
Supporting Statement B.docx Supporting Statement B Uploaded 2021-12-07 Available
Supporting Statement A.docx Supporting Statement A Uploaded 2021-12-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218949 Phase 2 Consent Form ModifiedAtt 8b_Phase 2 Behavioral Survey (Spanish)
218949 Phase 2 Consent Form ModifiedAtt 11a_Phase 2 Consent form (English)
218949 Phase 2 Consent Form Modified
218948 Phase 1 Consent Form and Instruction ModifiedAtt 10b_Phase 1 Consent Form (Spanish)
218948 Phase 1 Consent Form ModifiedPhase 1 Consent
218948 Phase 1 Consent Form Modified
218947 Phase 2 Behavioral Survey Form and Instruction ModifiedAtt 8b_Phase 2 Behavioral Survey (Spanish)
218947 Phase 2 Behavioral Survey Form and Instruction ModifiedAtt 8a_Phase 2 Behavioral Survey (English)
218947 Phase 2 Behavioral Survey Form and Instruction Modified
218946 Phase 2 HIV Symptom and Care Survey Form and Instruction ModifiedAtt 9b_Phase 2 HIV Symptom and Care Survey (Spanish)
218946 Phase 2 HIV Symptom and Care Survey Form and Instruction ModifiedAtt 9a_Phase 2 HIV Symptom and Care Survey (English)
218946 Phase 2 HIV Symptom and Care Survey Form and Instruction Modified
218945 Phase 1 Enrollment Survey Form and Instruction ModifiedAtt 7b_Phase 1 Enrollment Survey (Spanish)
218945 Phase 1 Enrollment Survey Form and Instruction ModifiedAtt 7a_Phase 1 Enrollment Survey (English)
218945 Phase 1 Enrollment Survey Form and Instruction Modified
218945 Phase 1 Enrollment Survey Other-Screenshot Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2025 36 Months From Approved 01/31/2022
4,751 0 4,751
1,594 0 1,594
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Phase 1 Consent 0920-1100, 0920-1100 ,  
Phase 1 Enrollment Survey 0920-1100, 0920-1100 ,  
Phase 2 Behavioral Survey 0920-1100, 0920-1100 ,  
Phase 2 Consent 0920-1100, 0920-1100 ,  
Phase 2 HIV Symptom and Care Survey 0920-1100, 0920-1100 ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,751 4,751 0 0 0 0
Annual Time Burden (Hours) 1,594 1,594 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No