Information Collection

A Positive Deviance Approach for Representing Women, Older Adults and Patients Identifying as Racial and Ethnic Minorities in Oncology Research

IC 260732 under ICR 202311-0910-005 · OMB 0910-0847.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0847 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Email Recruitment Flyer Positive Deviance FINAL.docx	Other-Email recruitment flyer
Email Recruitment Flyer Positive Deviance FINAL.docx	Other-Email recruitment flyer
Consent Form Positive Deviance FINAL.docx	Other-Consent form
Consent Form Positive Deviance FINAL.docx	Other-Consent form
Yale Mayo CERSI D8 Positive Deviance Demographic Survey FINAL.docx	Other-Demographic survey
Yale Mayo CERSI D8 Positive Deviance Demographic Survey FINAL.docx	Other-Demographic survey
Interview Guide Positive Deviance FINAL.docx	Other-Interview guide
Interview Guide Positive Deviance FINAL.docx	Other-Interview guide
Updated D8 IRB Approval Letter FINAL.pdf IRB	IC Document
Updated D8 IRB Approval Letter FINAL.pdf IRB	IC Document
0847 OMB Memo Positive Deviance FINAL.docx OMB Memo / Abbreviated Supporting Statement	IC Document
0847 OMB Memo Positive Deviance FINAL.docx OMB Memo / Abbreviated Supporting Statement	IC Document

IC Title:

A Positive Deviance Approach for Representing Women, Older Adults and Patients Identifying as Racial and Ethnic Minorities in Oncology Research

Agency IC Tracking Number:

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-Email recruitment flyer	Email Recruitment Flyer Positive Deviance FINAL.docx	Yes	Yes	Fillable Fileable
Other-Consent form	Consent Form Positive Deviance FINAL.docx	Yes	Yes	Fillable Fileable
Other-Demographic survey	Yale Mayo CERSI D8 Positive Deviance Demographic Survey FINAL.docx	Yes	Yes	Fillable Fileable
Other-Interview guide	Interview Guide Positive Deviance FINAL.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 24

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IRB	Updated D8 IRB Approval Letter FINAL.pdf	06/21/2023
OMB Memo / Abbreviated Supporting Statement	0847 OMB Memo Positive Deviance FINAL.docx	06/21/2023

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