Information Collection Request

Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)

ICR 202204-0920-005 · OMB 0920-1254 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1254 COVID-19 Case Follow-Up Questionnaire Form and Instruction New Repair queued
Form 0920-1254 AIS Questionnaire Form and Instruction New Repair queued
Form 0920-1254 AIS Text Message Form and Instruction New Repair queued
Form 0920-1254 Mobility Questionnaire Form and Instruction New Repair queued
Form 0920-18ANU Specimen Collection Form and Instruction Modified Repair queued
Form 0920-18ANU Vector Control Intervention Questionnaire Form and Instruction Modified Repair queued
Form 0920-18ANU Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction Modified Repair queued
Form 0920-18ANU Individual Questionnaire Form and Instruction Modified Repair queued
Form 0920-18ANU Household Representative Questionnaire Form and Instruction Modified Repair queued
Attachment 8_COPA questionnaires dropped questions.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 6_Consent summary.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 2_Consent Forms - All Ages.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 7_IRB approval letter 171110-VR_IRB.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
COPA Signed PIA.pdf Supplementary Document Uploaded 2022-04-07 Repair queued
Attachment 4_60 day FRN (2021-25449).pdf Supplementary Document Uploaded 2022-04-07 Repair queued
SSB COPA Revision 0920-1254.docx Supporting Statement B Uploaded 2022-04-07 Available
SSA COPA Revision 0920-1254.docx Supporting Statement A Uploaded 2022-04-07 Repair queued
10. COPA Flyer.pdf Supplementary Document Uploaded 2018-12-20 Repair queued
1. Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-12-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
252694 COVID-19 Case Follow-Up Questionnaire Form and Instruction New
252691 AIS Questionnaire Form and Instruction New
252686 AIS Text Message Form and Instruction New
252684 Mobility Questionnaire Form and Instruction New
234597 Specimen Collection Form and Instruction Modified
234596 Vector Control Intervention Questionnaire Form and Instruction Modified
234595 Knowledge, Attitudes, and Practices Individual Questionnaire Form and Instruction Modified
234594 Individual Questionnaire Form and Instruction Modified
234590 Household Representative Questionnaire Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
72,145 0
4,349 0
36,970 0





Reginfo record details
9
table that charts list of burden
IC Title Form No. Form Name
AIS Questionnaire 0920-1254 AIS Questionnaire - Data Collection Instruments (combined English/Spanish)
AIS Text Message 0920-1254 AIS Text Message - Data Collection Instruments (combined English/Spanish)
COVID-19 Case Follow-Up Questionnaire 0920-1254 COVID-19 Case Follow-Up Questionnaire
Household Representative Questionnaire 0920-18ANU, 0920-1254 Household Representative Questionnaire ,   Household Representative Questionnaire - Data Collection Instruments (combined English/Spanish)
Individual Questionnaire 0920-18ANU, 0920-18ANU, 0920-1254 Individual Questionnaire ,   Individual Questionnaire Spanish ,   Individual Questionnaire - Data Collection Instruments (combined English/Spanish)
Knowledge, Attitudes, and Practices Individual Questionnaire 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-18ANU, 0920-1254 KAP Adult ,   KAP Older Child ,   KAP Younger Child ,   Spanish KAP Adult ,   Spanish KAP Older Child ,   Spanish KAP Younger Child ,   Year Two Combined Questionnaire ,   Knowledge, Attitudes and Practices (KAP) Questionnaire - Data Collection Instruments (combined English/Spanish)
Mobility Questionnaire 0920-1254 Mobility Questionnaire - Data Collection Instruments (combined English/Spanish)
Specimen Collection 0920-18ANU, 0920-1254 Specimen Lab Form ,   Specimen Collection - Data Collection Instruments (combined English/Spanish)
Vector Control Intervention Questionnaire 0920-18ANU, 0920-18ANU, 0920-1254 Vector Control Questionnaire ,   Spanish Vector Control Questionnaire ,   Vector Control Questionnaire - Data Collection Instruments (combined English/Spanish)

table that charts list of burden
  Total Request 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 72,145 0 0 56,025 0 16,120
Annual Time Burden (Hours) 4,349 0 0 878 0 3,471
Annual Cost Burden (Dollars) 36,970 0 0 11,804 0 25,166


Reginfo record details
  No