Information Collection

Promising Themes Study

IC 255038 under ICR 202308-0910-006 · OMB 0910-0810.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0810 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1. Promising Themes Youth Assent.docx	Other-Youth assent
1. Promising Themes Youth Assent.docx	Other-Youth assent
2. Promising Themes Adult Consent.docx	Other-Adult consent
2. Promising Themes Adult Consent.docx	Other-Adult consent
3. Promising Themes LCC Screener Survey.docx	Other-Screener Survey
3. Promising Themes LCC Screener Survey.docx	Other-Screener Survey
4. Promising Themes Recruitment Ads.docx	Other-Recruitment ads
4. Promising Themes Recruitment Ads.docx	Other-Recruitment ads
Duke Version 4 and ICF Modification Approval Notice 6-9-22.pdf	Other-IRB
Duke Version 4 and ICF Modification Approval Notice 6-9-22.pdf	Other-IRB
SS part A Promising Themes 8-3-22.docx Supporting statement Part A Promising Themes	IC Document
SS part A Promising Themes 8-3-22.docx Supporting statement Part A Promising Themes	IC Document
SS part B Promising Themes 8-3-22.docx Supporting statement Part B Promising Themes	IC Document
SS part B Promising Themes 8-3-22.docx Supporting statement Part B Promising Themes	IC Document

IC Title:

Promising Themes Study

Agency IC Tracking Number:

CTP

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Youth assent	1. Promising Themes Youth Assent.docx	Yes	Yes	Fillable Fileable
Other-Adult consent	2. Promising Themes Adult Consent.docx	Yes	Yes	Fillable Fileable
Other-Screener Survey	3. Promising Themes LCC Screener Survey.docx	Yes	Yes	Fillable Fileable
Other-Recruitment ads	4. Promising Themes Recruitment Ads.docx	Yes	Yes	Printable Only
Other-IRB	Duke Version 4 and ICF Modification Approval Notice 6-9-22.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	1,022	1,022
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting statement Part A Promising Themes	SS part A Promising Themes 8-3-22.docx	08/03/2022
Supporting statement Part B Promising Themes	SS part B Promising Themes 8-3-22.docx	08/03/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.