Information Collection

Knowledge, Attitudes, and Practices (KAPs) of Hispanic/Latina Women of Reproductive Age: Focus Group Interview Guide

IC 263294 under ICR 202311-0920-006 · OMB 0920-1427.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-23AX Knowledge, Attitudes, and Practices (KAPs) of Hispanic/Latina Women of Reproductive Age: Focus Group Interview Guide	Form and Instruction
0920-23AX Online Screener English Attachment 20. Online Screener English.docx	Form and Instruction
0920-23AX Online Screener English Attachment 20. Online Screener English.docx	Form and Instruction
0920-23AX Online Screener Spanish Attachment 21. Online Screener Spanish.docx	Form and Instruction
0920-23AX Online Screener Spanish Attachment 21. Online Screener Spanish.docx	Form and Instruction
Attachment 35. Screenshots of Screener – English_202310.docx Attachment 35. Screenshots of Screener – English_202310	IC Document
Attachment 35. Screenshots of Screener – English_202310.docx Attachment 35. Screenshots of Screener – English_202310	IC Document
Attachment 36. Screenshots of Screener – Spanish_202310.docx Attachment 36. Screenshots of Screener – Spanish_202310	IC Document
Attachment 36. Screenshots of Screener – Spanish_202310.docx Attachment 36. Screenshots of Screener – Spanish_202310	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Knowledge, Attitudes, and Practices (KAPs) of Hispanic/Latina Women of Reproductive Age: Focus Group Interview Guide

Agency IC Tracking Number:

0920-23AX

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-23AX	Online Screener English	Attachment 20. Online Screener English.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-23AX	Online Screener Spanish	Attachment 21. Online Screener Spanish.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems #09-20-0136 , Department of Health and Human Services/CDC/National Center for Infectious Diseases. A privacy impact assessment

FR Citation: 57 FR 62811

Number of Respondents: 81

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	81	81
Annual IC Time Burden (Hours)	121	121
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 35. Screenshots of Screener â English_202310	Attachment 35. Screenshots of Screener â English_202310.docx	11/09/2023
Attachment 36. Screenshots of Screener â Spanish_202310	Attachment 36. Screenshots of Screener â Spanish_202310.docx	11/09/2023

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